{"reporting_entity_name":"Healthfirst Insurance Company","reporting_entity_type":"Health Insurance Issuer","last_updated_on":"2026-09-24","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":[1003378845],"tin":{"type":"npi","value":"1003378845"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003861725],"tin":{"type":"npi","value":"1003861725"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1184935264],"tin":{"type":"npi","value":"1184935264"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1487790259],"tin":{"type":"npi","value":"1487790259"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003042672],"tin":{"type":"npi","value":"1003042672"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003896929],"tin":{"type":"npi","value":"1003896929"}}]}],"in_network":[{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86039","name":"Antinuclear antibodies (ana)","description":"Antinuclear antibodies (ana); titer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67107","name":"Repair detached retina","description":"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"Phlebotomy","description":"Phlebotomy, therapeutic (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S1040","name":"Cranial remolding orthosis","description":"Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27054","name":"Removal of hip joint lining","description":"Arthrotomy with synovectomy, hip joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68335","name":"Revise/graft eyelid lining","description":"Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54522","name":"Orchiectomy partial","description":"Orchiectomy, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34900","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61055","name":"Injection into brain canal","description":"Cisternal or lateral cervical (c1-c2) puncture; with injection of medication or other substance for diagnosis or treatment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24640","name":"Cltx rdl head sublxtj nrsemd","description":"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26567","name":"Correct finger deformity","description":"Osteotomy; phalanx of finger, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88172","name":"Cytp dx eval fna 1st ea site","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43762","name":"Rplc gtube no revj trc","description":"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64617","name":"Chemodener muscle larynx emg","description":"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34702","name":"Evasc rpr a-ao ndgft rpt","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1630.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53040","name":"Drainage of urethra abscess","description":"Drainage of deep periurethral abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4057.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":5103.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77051","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93228","name":"Remote 30 day ecg rev/report","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82441","name":"Test for chlorohydrocarbons","description":"Chlorinated hydrocarbons, screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84134","name":"Assay of prealbumin","description":"Prealbumin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51940","name":"Correction of bladder defect","description":"Closure, exstrophy of bladder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1326.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26844","name":"Fusion/graft of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35221","name":"Rpr bld vsl dir intra-abdl","description":"Repair blood vessel, direct; intra-abdominal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1284.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44211","name":"Lap colectomy w/proctectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (s or j), with loop ileostomy, includes rectal mucosectomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84182","name":"Protein western blot test","description":"Protein; western blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP02","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46917","name":"Laser surgery anal lesions","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2011","name":"Alcohol/sub misuse assess","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11006","name":"Dbrdmt skin xtrnl gent per","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia, perineum and abdominal wall, with or without fascial closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93975","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87899","name":"Agent nos assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57291","name":"Construction of vagina","description":"Construction of artificial vagina; without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75791","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78268","name":"Urea breath test c-14 alys","description":"Urea breath test, c-14 (isotopic); analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73502","name":"X-ray exam hip uni 2-3 views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26492","name":"Tendon transfer with graft","description":"Opponensplasty; tendon transfer with graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27454","name":"Realignment of thigh bone","description":"Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (eg, sofield type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85390","name":"Fibrinolysins screen i&r","description":"Fibrinolysins or coagulopathy screen, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient compression arm sleeve and glove combination, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81337","name":"Smn1 gen nown famil seq vrnt","description":"Smn1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44602","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33533","name":"Cabg arterial single","description":"Coronary artery bypass, using arterial graft(s); single arterial graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4206","name":"1 cc sterile syringe&needle","description":"Syringe with needle, sterile, 1 cc or less, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP19","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95017","name":"All tstg perq&iq w/venoms","description":"Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with venoms, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95975","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44320","name":"Colostomy","description":"Colostomy or skin level cecostomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8100","name":"Spacer without mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; without mask","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6702.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15261","name":"Fth/gft fr n/e/e/l each addl","description":"Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75961","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1667.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38525","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep axillary node(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21480","name":"Cltx tmprmand dislc 1st/sbsq","description":"Closed treatment of temporomandibular dislocation; initial or subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58560","name":"Hysteroscopy resect septum","description":"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48551","name":"Prep donor pancreas","description":"Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile duct, ligation of mesenteric vessels, and y-graft arterial anastomoses from iliac artery to superio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25393","name":"Lengthen radius & ulna","description":"Osteoplasty, radius and ulna; lengthening with autograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":956.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53852","name":"Prostatic rf thermotx","description":"Transurethral destruction of prostate tissue; by radiofrequency thermotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80166","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3670.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76125","name":"Cine/video x-rays add-on","description":"Cineradiography/videoradiography to complement routine examination (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86160","name":"Complement antigen","description":"Complement; antigen, each component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87541","name":"Legion pneumo dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5980.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40812","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93922","name":"Upr/l xtremity art 2 levels","description":"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waveform recording and analysis at 1-2 levels, or ankle/brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52647","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1311.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96446","name":"Chemotx admn pertl cav impl","description":"Chemotherapy administration into the peritoneal cavity via implanted port or catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77411","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78430","name":"Myocrd img pet rst/strs w/ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15610","name":"Delay flap arms/legs","description":"Delay of flap or sectioning of flap (division and inset); at scalp, arms, or legs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64625","name":"Rf abltj nrv nrvtg si jt","description":"Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1578.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51520","name":"Removal of bladder lesion","description":"Cystotomy; for simple excision of vesical neck (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32150","name":"Removal of lung lesion(s)","description":"Thoracotomy; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95979","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41830","name":"Removal of gum tissue","description":"Alveolectomy, including curettage of osteitis or sequestrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69643","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28055","name":"Neurectomy foot","description":"Neurectomy, intrinsic musculature of foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76376","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88245","name":"Chromosome analysis 20-25","description":"Chromosome analysis for breakage syndromes; baseline sister chromatid exchange (sce), 20-25 cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15156","name":"Tis clt agrft f/s/n/h/f/g ad","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; additional 1 sq cm to 75 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24802","name":"Arthrd elbow jt autog graft","description":"Arthrodesis, elbow joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26060","name":"Incision of finger tendon","description":"Tenotomy, percutaneous, single, each digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55812","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60281","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus; recurrent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93459","name":"L hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter place","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61320","name":"Crnec/crnot drg icr abs sttl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1736.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99493","name":"Sbsq psyc collab care mgmt","description":"Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required el","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92583","name":"Select picture audiometry","description":"Select picture audiometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","name":"Anes opn rpr fx disrpj plvs","description":"Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9984","name":"Remote e/m est. pt 15mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: an expanded problem focused history;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33031","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61582","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2757.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93622","name":"Comp ep eval l ventr pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1987.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92585","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92508","name":"Tx sp lang voice comm group","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27047","name":"Exc hip/pelvis les sc < 3 cm","description":"Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20972","name":"Bone/skin graft metatarsal","description":"Free osteocutaneous flap with microvascular anastomosis; metatarsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2421.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8101","name":"Spacer with mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; with mask","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21261","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2059.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85046","name":"Reticyte/hgb concentrate","description":"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content [chr], immature reticulocyte fraction [irf], reticulocyte volume [mrv], rna content), direct measurement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440T","name":"Abltj perc uxtr/perph nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49653","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78431","name":"Myocrd img pet rst&strs ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1776.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28400","name":"Cltx calcaneal fx w/o mnpj","description":"Closed treatment of calcaneal fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58957","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28292","name":"Cor hlx vlgs rsc prx phlx bs","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with resection of proximal phalanx base, when performed, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58541","name":"Lsh uterus 250 g or less","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58292","name":"Vag hyst t/o & repair compl","description":"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96146","name":"Psycl/nrpsyc tst auto result","description":"Psychological or neuropsychological test administration, with single automated, standardized instrument via electronic platform, with automated result only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75660","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61026","name":"Injection into brain canal","description":"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72194","name":"Ct pelvis w/o & w/dye","description":"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69642","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0145","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78266","name":"Gstr empt img sm bwl&colon","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11740","name":"Evacuation subungual hmtma","description":"Evacuation of subungual hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46761","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (park posterior anal repair)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57283","name":"Colpopexy intraperitoneal","description":"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82666","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31205","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; extranasal, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62361","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00942","name":"Anes vag px clptmy vgnc clpr","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); colpotomy, vaginectomy, colporrhaphy, and open urethral procedures","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61797","name":"Srs cran les simple addl","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2061","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87536","name":"Hiv-1 quant&revrse trnscrpj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, quantification, includes reverse transcription when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86153","name":"Cell enumeration phys interp","description":"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); physician interpretation and report, when required","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50100","name":"Trnsxj/repos abrrnt rnl vsls","description":"Transection or repositioning of aberrant renal vessels (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93016","name":"Cv stress test supvj only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86063","name":"Antistreptolysin o screen","description":"Antistreptolysin 0; screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58611","name":"Ligate oviduct(s) add-on","description":"Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0271","name":"Group mnt 2 or more 30 mins","description":"Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71555","name":"Mri angio chest w or w/o dye","description":"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00756","name":"Anes hrna rpr diphrg hrna","description":"Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44157","name":"Colectomy w/ileoanal anast","description":"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, includes loop ileostomy, and rectal mucosectomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63195","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37650","name":"Ligation of femoral vein","description":"Ligation of femoral vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26320","name":"Removal of implant from hand","description":"Removal of implant from finger or hand","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43234","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45347","name":"Sigmoidoscopy w/plcmt stent","description":"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15787","name":"Abrasion lesions add-on","description":"Abrasion; each additional 4 lesions or less (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26546","name":"Repair nonunion hand","description":"Repair non-union, metacarpal or phalanx (includes obtaining bone graft with or without external or internal fixation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33910","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2325.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84066","name":"Assay prostate phosphatase","description":"Phosphatase, acid; prostatic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":105.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90829","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90473","name":"Immune admin oral/nasal","description":"Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76000","name":"Fluoroscopy <1 hr phys/qhp","description":"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","name":"Anes px crv spn&cord sitting","description":"Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86738","name":"Mycoplasma antibody","description":"Antibody; mycoplasma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27831","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19325","name":"Breast augmentation w/implt","description":"Breast augmentation with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9481","name":"Remote e/m new pt 10mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furni","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58267","name":"Vag hyst w/urinary repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (marshall-marchetti-krantz type, pereyra type) with or without endoscopic control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3608.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57267","name":"Insert mesh/pelvic flr addon","description":"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1470.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21485","name":"Cltx tmprmand dislc comp","description":"Closed treatment of temporomandibular dislocation; complicated (eg, recurrent requiring intermaxillary fixation or splinting), initial or subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47543","name":"Endoluminal bx biliary tree","description":"Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, single or multiple (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2011","name":"Alcohol/sub misuse assess","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44650","name":"Repair bowel fistula","description":"Closure of enteroenteric or enterocolic fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47900","name":"Suture bile duct injury","description":"Suture of extrahepatic biliary duct for pre-existing injury (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1139.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34701","name":"Evasc rpr a-ao ndgft","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36226","name":"Place cath vertebral art","description":"Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1604.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43401","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0238T","name":"Trluml perip athrc iliac art","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; iliac artery, each vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9507.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37252","name":"Intrvasc us noncoronary 1st","description":"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42820","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; younger than age 12","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99324","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97028","name":"Ultraviolet therapy","description":"Application of a modality to 1 or more areas; ultraviolet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28210","name":"Repair/graft of foot tendon","description":"Repair, tendon, extensor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27227","name":"Treat hip fracture(s)","description":"Open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, with internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1403.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77422","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75665","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","name":"Anes ther ivntl rad artl nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3649","name":"Orthopedic shoe modifica nos","description":"Orthopedic shoe, modification, addition or transfer, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4978.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87290","name":"Varicella zoster ag if","description":"Infectious agent antigen detection by immunofluorescent technique; varicella zoster virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81329","name":"Smn1 gene dos/deletion alys","description":"Smn1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes smn2 (survival of motor neuron 2, centromeric) analysis, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93452","name":"Left hrt cath w/ventrclgrphy","description":"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0146T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37650","name":"Ligation of femoral vein","description":"Ligation of femoral vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87620","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75901","name":"Remove cva device obstruct","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60252","name":"Removal of thyroid","description":"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1116.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85049","name":"Automated platelet count","description":"Blood count; platelet, automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46742","name":"Repair of imperforated anus","description":"Repair of high imperforate anus with rectourethral or rectovaginal fistula; combined transabdominal and sacroperineal approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2086.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94780","name":"Cars/bd tst inft-12mo 60 min","description":"Car seat/bed testing for airway integrity, for infants through 12 months of age, with continual clinical staff observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; 60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","name":"Anes hernia repair<1 yr age","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, younger than 1 year of age","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87910","name":"Nfct agt gntyp alys cmv","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); cytomegalovirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87168","name":"Macroscopic exam arthropod","description":"Macroscopic examination; arthropod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5475.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35331","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; abdominal aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68420","name":"I&d lacrimal sac","description":"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35456","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74248","name":"X-ray sm int f-thru std","description":"Radiologic small intestine follow-through study, including multiple serial images (list separately in addition to code for primary procedure for upper gi radiologic examination)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99607","name":"Mtms by pharm addl 15 min","description":"Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32651","name":"Thoracoscopy remove cortex","description":"Thoracoscopy, surgical; with partial pulmonary decortication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28570","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73722","name":"Mri joint of lwr extr w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86885","name":"Coombs test indirect qual","description":"Antihuman globulin test (coombs test); indirect, qualitative, each reagent red cell","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6215","name":"Foam dressing wound filler","description":"Foam dressing, wound filler, sterile, per gram","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2440.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24341","name":"Rpr tdn/musc upr a/e each","description":"Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11044","name":"Dbrdmt bone 1st 20 sq cm/<","description":"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40525","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with local flap (eg, estlander or fan)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58345","name":"Reopen fallopian tube","description":"Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80051","name":"Electrolyte panel","description":"Electrolyte panel this panel must include the following: carbon dioxide (bicarbonate) (82374) chloride (82435) potassium (84132) sodium (84295)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47380","name":"Open ablate liver tumor rf","description":"Ablation, open, of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87270","name":"Chlamydia trachomatis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; chlamydia trachomatis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43610","name":"Excision of stomach lesion","description":"Excision, local; ulcer or benign tumor of stomach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP11","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74246","name":"X-ray xm upr gi trc 2cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0085","name":"Care man h v ext pt 75 m","description":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44955","name":"Appendectomy add-on","description":"Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26118","name":"Rad resect hand tumor 3 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87536","name":"Hiv-1 quant&revrse trnscrpj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, quantification, includes reverse transcription when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29804","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, surgical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0326","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77407","name":"Radiation tx delivery lvl 2","description":"Radiation treatment delivery; level 2, single-isocenter (eg, 3d or imrt), photons, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86922","name":"Compatibility test antiglob","description":"Compatibility test each unit; antiglobulin technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89050","name":"Body fluid cell count","description":"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63090","name":"Remove vert body dcmprn lmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1712.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3216","name":"Orthoped ladies shoes dpth i","description":"Orthopedic footwear, ladies shoe, depth inlay, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27466","name":"Lengthening of thigh bone","description":"Osteoplasty, femur; lengthening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73550","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91010","name":"Esophagus motility study","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26135","name":"Revise finger joint each","description":"Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood reconstruction, each digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64489","name":"Tap block bi by infusion","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4580","name":"Cast supplies (plaster)","description":"Cast supplies (e.g., plaster)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88177","name":"Cytp fna eval ea addl","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4770","name":"Blood collection tube/vacuum","description":"Blood collection tube, vacuum, for dialysis, per 50","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82690","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","name":"Anes thrc spine w/1 lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82670","name":"Assay of total estradiol","description":"Estradiol; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31520","name":"Dx laryngoscopy newborn","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60212","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21390","name":"Opn tx orbit periorbtl implt","description":"Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0171T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29830","name":"Elbow arthroscopy","description":"Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88318","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33724","name":"Repair venous anomaly","description":"Repair of isolated partial anomalous pulmonary venous return (eg, scimitar syndrome)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64635","name":"Destroy lumb/sac facet jnt","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); lumbar or sacral, single facet joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76936","name":"Echo guide for artery repair","description":"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15151","name":"Tis cltr skn agrft t/a/l add","description":"Tissue cultured skin autograft, trunk, arms, legs; additional 1 sq cm to 75 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51050","name":"Removal of bladder stone","description":"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42809","name":"Remove pharynx foreign body","description":"Removal of foreign body from pharynx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4526.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99191","name":"Special pump services","description":"Assembly and operation of pump with oxygenator or heat exchanger (with or without ecg and/or pressure monitoring); 45 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19085","name":"Bx breast 1st lesion mr imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including magnetic resonance guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23630","name":"Optx gr hmrl tbrs fx int fix","description":"Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":84.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27050","name":"Biopsy of sacroiliac joint","description":"Arthrotomy, with biopsy; sacroiliac joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58976","name":"Transfer of embryo","description":"Gamete, zygote, or embryo intrafallopian transfer, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53460","name":"Revision of urethra","description":"Urethromeatoplasty, with partial excision of distal urethral segment (richardson type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29046","name":"Appl bdy cst sho to hip b th","description":"Application of body cast, shoulder to hips; including both thighs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36228","name":"Place cath intracranial art","description":"Selective catheter placement, each intracranial branch of the internal carotid or vertebral arteries, unilateral, with angiography of the selected vessel circulation and all associated radiological supervision and interpretation (eg, middle cerebral artery, posterior inferior cerebellar artery) (lis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84704","name":"Hcg free betachain test","description":"Gonadotropin, chorionic (hcg); free beta chain","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34530","name":"Leg vein fusion","description":"Saphenopopliteal vein anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27762","name":"Cltx med ankle fx w/mnpj","description":"Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2881.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99183","name":"Hyperbaric oxygen therapy","description":"Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49496","name":"Rpr ing hernia baby blocked","description":"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76936","name":"Echo guide for artery repair","description":"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86707","name":"Hepatitis be antibody","description":"Hepatitis be antibody (hbeab)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87517","name":"Hepatitis b dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis b virus, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25430","name":"Vasc graft into carpal bone","description":"Insertion of vascular pedicle into carpal bone (eg, hori procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"Acoustic refl threshold tst","description":"Acoustic reflex testing, threshold","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69715","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90875","name":"Psychophysiological therapy","description":"Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5097.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10080","name":"I&d pilonidal cyst simple","description":"Incision and drainage of pilonidal cyst; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3995.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87592","name":"N.gonorrhoeae dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32422","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86880","name":"Coombs test direct","description":"Antihuman globulin test (coombs test); direct, each antiserum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6020.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29710","name":"Rmvl/bivlv sho/hip spica","description":"Removal or bivalving; shoulder or hip spica, minerva, or risser jacket, etc.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2749.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2596.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1396.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73702","name":"Ct lwr extremity w/o&w/dye","description":"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27256","name":"Treat hip dislocation","description":"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; without anesthesia, without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3217","name":"Ladies shoes hightop depth i","description":"Orthopedic footwear, ladies shoe, hightop, depth inlay, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55706","name":"Bx prst8 ndl sat sampling","description":"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66185","name":"Revise aqueous shunt eye","description":"Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"Off/op est may x req phy/qhp","description":"Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64885","name":"Nerve graft head/neck <4 cm","description":"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","name":"Anes thrc spine w/1 lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63278","name":"Bx/exc xdrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1450.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36476","name":"Endovenous rf vein add-on","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66825","name":"Reposition intraocular lens","description":"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35091","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1579.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12054","name":"Intmd rpr face/mm 7.6-12.5cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88162","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25065","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91035","name":"G-esoph reflx tst w/electrod","description":"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry ph electrode placement, recording, analysis and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88388","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35522","name":"Art byp grft axill-brachial","description":"Bypass graft, with vein; axillary-brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8680","name":"Implt neurostim elctr each","description":"Implantable neurostimulator electrode, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25109","name":"Excise tendon forearm/wrist","description":"Excision of tendon, forearm and/or wrist, flexor or extensor, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28312","name":"Revision of toe","description":"Osteotomy, shortening, angular or rotational correction; other phalanges, any toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64704","name":"Revise hand/foot nerve","description":"Neuroplasty; nerve of hand or foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15366","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33977","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01820","name":"Anes clsd px rds u/w/h bones","description":"Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00326","name":"Anes all px larynx&trach<1yr","description":"Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44369","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63280","name":"Bx/exc idrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1938.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69300","name":"Revise external ear","description":"Otoplasty, protruding ear, with or without size reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76816","name":"Ob us follow-up per fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetu","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17350.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0047","name":"Alcohol/drug abuse svc nos","description":"Alcohol and/or other drug abuse services, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61055","name":"Injection into brain canal","description":"Cisternal or lateral cervical (c1-c2) puncture; with injection of medication or other substance for diagnosis or treatment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70482","name":"Ct orbit/ear/fossa w/o&w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69802","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4524","name":"Adult size brief/diaper xl","description":"Adult sized disposable incontinence product, brief/diaper, extra large, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87425","name":"Rotavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; rotavirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11730","name":"Avulsion nail plate simple 1","description":"Avulsion of nail plate, partial or complete, simple; single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43236","name":"Uppr gi scope w/submuc inj","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2214","name":"Init/sub psych care m 1st 30","description":"Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12042","name":"Intmd rpr n-hf/genit2.6-7.5","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01272","name":"Anes px art femoral art lig","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery ligation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29898","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7510","name":"Prosthetic device repair rep","description":"Repair of prosthetic device, repair or replace minor parts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57425","name":"Laparoscopy surg colpopexy","description":"Laparoscopy, surgical, colpopexy (suspension of vaginal apex)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23170","name":"Sequestrectomy clavicle","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), clavicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3493.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45562","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3825.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12018","name":"Rpr f/e/e/n/l/m >30.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64896","name":"Nrv grf mltst hnd/foot >4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1215.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31561","name":"Larynscop remve cart + scop","description":"Laryngoscopy, direct, operative, with arytenoidectomy; with operating microscope or telescope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21465","name":"Optx mndblr cndylr fx","description":"Open treatment of mandibular condylar fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84100","name":"Assay of phosphorus","description":"Phosphorus inorganic (phosphate);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29851","name":"Knee arthroscopy/surgery","description":"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53220","name":"Treatment of urethra lesion","description":"Excision or fulguration of carcinoma of urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3001.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95870","name":"Ndl emg lmtd std musc 1 xtr","description":"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46742","name":"Repair of imperforated anus","description":"Repair of high imperforate anus with rectourethral or rectovaginal fistula; combined transabdominal and sacroperineal approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2086.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80076","name":"Hepatic function panel","description":"Hepatic function panel this panel must include the following: albumin (82040) bilirubin, total (82247) bilirubin, direct (82248) phosphatase, alkaline (84075) protein, total (84155) transferase, alanine amino (alt) (sgpt) (84460) transferase, aspartate amino (ast) (sgot) (84450)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21700","name":"Revision of neck muscle","description":"Division of scalenus anticus; without resection of cervical rib","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65430","name":"Corneal smear","description":"Scraping of cornea, diagnostic, for smear and/or culture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42972","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); with secondary surgical intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53620","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67805","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, different lids","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47144","name":"Prep donor liver 3-segment","description":"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with trisegmen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27306","name":"Incision of thigh tendon","description":"Tenotomy, percutaneous, adductor or hamstring; single tendon (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43191","name":"Esophagoscopy rigid trnso dx","description":"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87804","name":"Influenza assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; influenza","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92979","name":"Endoluminl ivus oct c ea","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to co","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95801","name":"Slp stdy unatnd w/anal","description":"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10120","name":"Inc&rmvl fb subq tiss smpl","description":"Incision and removal of foreign body, subcutaneous tissues; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73523","name":"X-ray exam hips bi 5/> views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2260.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53600","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93288","name":"Interrog evl pm/ldls pm ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system, or leadless pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31241","name":"Nsl/sns ndsc lig sphnptn art","description":"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96133","name":"Nrpsyc tst eval phys/qhp ea","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the pati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"Home/res vst est sf mdm 20","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceede","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7769.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43252","name":"Egd optical endomicroscopy","description":"Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37210","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3860.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76811","name":"Ob us detailed sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35363","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliofemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43832","name":"Gstrst open w/constj tube","description":"Gastrostomy, open; with construction of gastric tube (eg, janeway procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49452","name":"Replace g-j tube perc","description":"Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82805","name":"Blood gases w/o2 saturation","description":"Gases, blood, any combination of ph, pco2, po2, co2, hco3 (including calculated o2 saturation); with o2 saturation, by direct measurement, except pulse oximetry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27005","name":"Tenotomy hip flexor open","description":"Tenotomy, hip flexor(s), open (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53621","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78454","name":"Ht musc image planar mult","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52290","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2014","name":"Post-d/c care plan overs 30m","description":"Limited (30 minutes) care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15171","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23931","name":"I&d upr a/e bursa","description":"Incision and drainage, upper arm or elbow area; bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0200T","name":"Perq sacral augmt unilat inj","description":"Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, 1 or more needles, includes imaging guidance and bone biopsy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"Vnpnxr<3yrs phy/qhp other vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; other vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27412","name":"Autochondrocyte implant knee","description":"Autologous chondrocyte implantation, knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15200","name":"Fth/gft fr trnk 20 sq cm/<","description":"Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92134","name":"Cptrz oph dx img pst sgm rta","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47700","name":"Exploration of bile ducts","description":"Exploration for congenital atresia of bile ducts, without repair, with or without liver biopsy, with or without cholangiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71552","name":"Mri chest w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94644","name":"Cont inhlj tx 1st hour","description":"Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26608","name":"Treat metacarpal fracture","description":"Percutaneous skeletal fixation of metacarpal fracture, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01232","name":"Anes opn px upr 2/3 fem amp","description":"Anesthesia for open procedures involving upper two-thirds of femur; amputation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0149T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84376","name":"Sugars single qual","description":"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22505","name":"Manipulation of spine","description":"Manipulation of spine requiring anesthesia, any region","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57022","name":"I&d vaginal hematoma ob/pp","description":"Incision and drainage of vaginal hematoma; obstetrical/postpartum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87102","name":"Fungus isolation culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581T","name":"Abltj mal brst tum perq crtx","description":"Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33730","name":"Repair heart-vein defect(s)","description":"Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1743.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36585","name":"Replace picvad cath","description":"Replacement, complete, of a peripherally inserted central venous access device, with subcutaneous port, through same venous access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81121","name":"Idh2 common variants","description":"Idh2 (isocitrate dehydrogenase 2 [nadp+], mitochondrial) (eg, glioma), common variants (eg, r140w, r172m)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35626","name":"Bpg aor-subcla/innom/carotid","description":"Bypass graft, with other than vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1387.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8990","name":"Pt or manip for maint","description":"Physical or manipulative therapy performed for maintenance rather than restoration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13133","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","description":"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","name":"Anes px ear w/bx nos","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30220","name":"Insert nasal septal button","description":"Insertion, nasal septal prosthesis (button)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1827.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27240","name":"Treat thigh fracture","description":"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87904","name":"Phenotype dna hiv w/clt add","description":"Infectious agent phenotype analysis by nucleic acid (dna or rna) with drug resistance tissue culture analysis, hiv 1; each additional drug tested (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99144","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26502","name":"Hand tendon reconstruction","description":"Reconstruction of tendon pulley, each tendon; with tendon or fascial graft (includes obtaining graft) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83505","name":"Assay total hydroxyproline","description":"Hydroxyproline; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88361","name":"Tumor immunohistochem/comput","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28005","name":"Treat foot bone lesion","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35276","name":"Rpr blvs gr ot/t vn ntrth wo","description":"Repair blood vessel with graft other than vein; intrathoracic, without bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25028","name":"I&d f/arm&/wrst dp absc/hmtm","description":"Incision and drainage, forearm and/or wrist; deep abscess or hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2096.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96118","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"Office o/p new hi 60 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63290","name":"Bx/exc xdrl/idrl lsn any lvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2570.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43341","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); thoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29880","name":"Arthrs kne srg mnisectmy m&l","description":"Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27509","name":"Treatment of thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, distal end, medial or lateral condyle, or supracondylar or transcondylar, with or without intercondylar extension, or distal femoral epiphyseal separation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43206","name":"Esoph optical endomicroscopy","description":"Esophagoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":451.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83789","name":"Mass spectrometry qual/quan","description":"Mass spectrometry and tandem mass spectrometry (eg, ms, ms/ms, maldi, ms-tof, qtof), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55200","name":"Incision of sperm duct","description":"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2565.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81167","name":"Brca2 gene full dup/del alys","description":"Brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21240","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26755","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","name":"Anes integumentary sys nos","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70549","name":"Mr angiograph neck w/o&w/dye","description":"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87209","name":"Smear complex stain","description":"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93229","name":"Remote 30 day ecg tech supp","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0103","name":"Psa screening","description":"Prostate cancer screening; prostate specific antigen test (psa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33956","name":"Ecmo/ecls insj ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, 6 years and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3786.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2352.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29892","name":"Arthrs aid rpr od les/tib fx","description":"Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63044","name":"Laminotomy addl lumbar","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional lumbar interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29881","name":"Arthrs kne srg mnisectmy m/l","description":"Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43116","name":"Partial removal of esophagus","description":"Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4180.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5329.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81305","name":"Myd88 gene p.leu265pro vrnt","description":"Myd88 (myeloid differentiation primary response 88) (eg, waldenstroms macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.leu265pro (l265p) variant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0130","name":"Single energy x-ray study","description":"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84035","name":"Assay of phenylketones","description":"Phenylketones, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69950","name":"Incise inner ear nerve","description":"Vestibular nerve section, transcranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1427.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84220","name":"Assay of pyruvate kinase","description":"Pyruvate kinase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","name":"Anes px male gent orchiopexy","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32602","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69401","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29855","name":"Tibial arthroscopy/surgery","description":"Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86079","name":"Phys blood bank serv authrj","description":"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of rh incompatible units), with written report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95726","name":"Eeg phy/qhp>84 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of eeg recording, with video (veeg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21296","name":"Revision of jaw muscle/bone","description":"Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); intraoral approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":419.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64590","name":"Ins/rpl prph sac/gstr npg/r","description":"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4220","name":"Infusion pump refill kit","description":"Refill kit for implantable infusion pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27893","name":"Decompression of leg","description":"Decompression fasciotomy, leg; posterior compartment(s) only, with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28080","name":"Removal of foot lesion","description":"Excision, interdigital (morton) neuroma, single, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87338","name":"Hpylori stool ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; helicobacter pylori, stool","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92523","name":"Speech sound lang comprehen","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29828","name":"Sho arthrs srg bicp tenodsis","description":"Arthroscopy, shoulder, surgical; biceps tenodesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42450","name":"Excise sublingual gland","description":"Excision of sublingual gland","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82735","name":"Assay of fluoride","description":"Fluoride","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4197","name":"Parenteral sol 74-100 gm pro","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2355.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81239","name":"Dmpk gene charac alleles","description":"Dmpk (dm1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1832.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35304","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; tibioperoneal trunk artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35491","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36474","name":"Endovenous mchnchem add-on","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99380","name":"Nursing fac care supervision","description":"Supervision of a nursing facility patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, comm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75952","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1731.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1267.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37182","name":"Insert hepatic shunt (tips)","description":"Insertion of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract formation/dilatation, stent placement and all associated imaging guidance and documentation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2482.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29837","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93981","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4978.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3204","name":"Hightop w/ supp/pronator inf","description":"Orthopedic shoe, hightop with supinator or pronator, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43757","name":"Dx duod intub w/asp specs","description":"Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes drug administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62290","name":"Njx px discography lumbar","description":"Injection procedure for discography, each level; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44661","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; with intestine and/or bladder resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1270.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","name":"Anes c hyst flwg neuraxial","description":"Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":925.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34151","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; renal, celiac, mesentery, aortoiliac artery, by abdominal incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99244","name":"Off/op cnsltj new/est mod 40","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99417","name":"Prolng op e/m each 15 min","description":"Prolonged outpatient evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the code of the outpa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33259","name":"Ablate atria w/bypass add-on","description":"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4419.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20703","name":"Rmvl imed rx delivery device","description":"Removal of drug-delivery device(s), intramedullary (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74247","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92083","name":"Extended visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, hump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91300","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28041","name":"Exc foot/toe tum dep 1.5cm/>","description":"Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); 1.5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95081.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24150","name":"Rad rescj tum dstl/shft hum","description":"Radical resection of tumor, shaft or distal humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1314.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10737.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83500","name":"Assay free hydroxyproline","description":"Hydroxyproline; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20225","name":"Bone biopsy trocar/ndl deep","description":"Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50945","name":"Laparoscopy ureterolithotomy","description":"Laparoscopy, surgical; ureterolithotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2909.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33203","name":"Insert epicard eltrd endo","description":"Insertion of epicardial electrode(s); endoscopic approach (eg, thoracoscopy, pericardioscopy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51705","name":"Change of bladder tube","description":"Change of cystostomy tube; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93922","name":"Upr/l xtremity art 2 levels","description":"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waveform recording and analysis at 1-2 levels, or ankle/brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19284","name":"Perq dev breast add strtctc","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including stereotactic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20705","name":"Rmvl i-artic rx delivery dev","description":"Removal of drug-delivery device(s), intra-articular (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45378","name":"Diagnostic colonoscopy","description":"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","53"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58720","name":"Removal of ovary/tube(s)","description":"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36680","name":"Insert needle bone cavity","description":"Placement of needle for intraosseous infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92579","name":"Visual audiometry (vra)","description":"Visual reinforcement audiometry (vra)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64435","name":"Njx aa&/strd paracrv nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70549","name":"Mr angiograph neck w/o&w/dye","description":"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12055","name":"Intmd rpr face/mm 12.6-20 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42400","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64616","name":"Chemodenerv musc neck dyston","description":"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75563","name":"Card mri w/stress img & dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61575","name":"Skull base/brainstem surgery","description":"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2303.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","name":"Anes opn/arthr elb tot rplct","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92018","name":"Compl oph exam general anes","description":"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54057","name":"Laser surg penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23515","name":"Optx clavicular fx w/int fix","description":"Open treatment of clavicular fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0107T","name":"Vibrate quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using vibration stimuli to assess large diameter fiber sensation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":520.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11765","name":"Wedge excision skn nail fold","description":"Wedge excision of skin of nail fold (eg, for ingrown toenail)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8428","name":"Ready gradient gauntlet","description":"Gradient pressure aid (gauntlet), ready made","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","name":"Anes ther ivntl rad px icr","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67255","name":"Reinforce/graft eye wall","description":"Scleral reinforcement (separate procedure); with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94727","name":"Gas dil/wshot deter lng vol","description":"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71552","name":"Mri chest w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32491","name":"Lung volume reduction","description":"Removal of lung, other than pneumonectomy; with resection-plication of emphysematous lung(s) (bullous or non-bullous) for lung volume reduction, sternal split or transthoracic approach, includes any pleural procedure, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1174.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57155","name":"Insert uteri tandem/ovoids","description":"Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28001","name":"Drainage of bursa of foot","description":"Incision and drainage, bursa, foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29877","name":"Arthrs knee surg dbrdmt/shvg","description":"Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67810","name":"Incal bx eyelid skn lid mrgn","description":"Incisional biopsy of eyelid skin including lid margin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14621.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0115","name":"Post-coital mucous exam","description":"Post-coital direct, qualitative examinations of vaginal or cervical mucous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15101","name":"Splt agrft t/a/l ea addl 100","description":"Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78584","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88150","name":"Cytopath c/v manual","description":"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36821","name":"Av fusion direct any site","description":"Arteriovenous anastomosis, open; direct, any site (eg, cimino type) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28120","name":"Part removal of ankle/heel","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); talus or calcaneus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1460.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36576","name":"Repair tunneled cv cath","description":"Repair of central venous access device, with subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74251","name":"X-ray xm sm int 2cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3656.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KC","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92571","name":"Filtered speech test","description":"Filtered speech test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90999","name":"Unlisted dialysis procedure","description":"Unlisted dialysis procedure, inpatient or outpatient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4333.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69105","name":"Biopsy of external ear canal","description":"Biopsy external auditory canal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75959","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","name":"Emergency dept visit mod mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70470","name":"Ct head/brain w/o & w/dye","description":"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22533","name":"Arthrd lat xtrcvtry tq lmbr","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27722","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with sliding graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22527","name":"Idet 1 or more levels","description":"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; 1 or more additional levels (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1508.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35741","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93566","name":"Njx car cth slctv rv/ra ang","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93510","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86708","name":"Hepatitis a antibody","description":"Hepatitis a antibody (haab)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0329","name":"Electromagntic tx for ulcers","description":"Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5876.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93017","name":"Cv stress test tracing only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9685","name":"Acute nursing facility care","description":"Physician service or other qualified health care professional for the evaluation and management of a beneficiarys acute change in condition in a nursing facility. this service is for a demonstration project","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62192","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36909","name":"Dialysis circuit embolj","description":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation necessary to complete the intervention (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":996.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP02","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57023","name":"I&d vaginal hematoma non-ob","description":"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29730","name":"Windowing of cast","description":"Windowing of cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63050","name":"Cervical laminoplsty 2/> seg","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0191T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"Off/op est may x req phy/qhp","description":"Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4526","name":"Adult size pull-on med","description":"Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92975","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20225","name":"Bone biopsy trocar/ndl deep","description":"Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0425","name":"Inpt/ed teleconsult30","description":"Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28107","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0130","name":"Single energy x-ray study","description":"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35761","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61680","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2062.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58346","name":"Insert heyman uteri capsule","description":"Insertion of heyman capsules for clinical brachytherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53605","name":"Dilate urethra stricture","description":"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92014","name":"Compre oph exam est pt 1/>","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27415","name":"Osteochondral knee allograft","description":"Osteochondral allograft, knee, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52354","name":"Cystouretero w/biopsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","name":"Anes integumentary sys nos","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83045","name":"Hgb methemoglobin qual","description":"Hemoglobin; methemoglobin, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47561","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0238T","name":"Trluml perip athrc iliac art","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; iliac artery, each vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9507.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95146","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 2 single stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52327","name":"Cystoscopy inject material","description":"Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50551","name":"Kidney endoscopy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67250","name":"Reinforce eye wall","description":"Scleral reinforcement (separate procedure); without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19125","name":"Excision breast lesion","description":"Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C9113","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82657","name":"Enzyme cell activity","description":"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0232T","name":"Njx platelet plasma","description":"Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71023","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59100","name":"Remove uterus lesion","description":"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90829","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47539","name":"Perq plmt bile duct stent","description":"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; new access,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3638.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87517","name":"Hepatitis b dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis b virus, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77300","name":"Radiation therapy dose plan","description":"Basic radiation dosimetry calculation, central axis depth dose calculation, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61698","name":"Brain aneurysm repr complx","description":"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4505.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","name":"Anes xtrprtl lwr abd rnl px","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","name":"Anes opn/arthrs knee jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94070","name":"Evaluation of wheezing","description":"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52700","name":"Drainage of prostate abscess","description":"Transurethral drainage of prostatic abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23585","name":"Optx scapular fx w/int fixj","description":"Open treatment of scapular fracture (body, glenoid or acromion) includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92526","name":"Oral function therapy","description":"Treatment of swallowing dysfunction and/or oral function for feeding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93624","name":"Ep f-up study pacg&rec","description":"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24576","name":"Cltx humrl cndylr fx wo mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88262","name":"Chromosome analysis 15-20","description":"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83921","name":"Organic acid single quant","description":"Organic acid, single, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33962","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50947","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4189","name":"Parenteral sol amino acid &","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33948","name":"Ecmo/ecls daily mgmt-venous","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; daily management, each day, veno-venous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93287","name":"Peri-px device eval & prgr","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66020","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); air or liquid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KC","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93460","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47120","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; partial lobectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96902","name":"Mcrscp xm hair pluck/clipped","description":"Microscopic examination of hairs plucked or clipped by the examiner (excluding hair collected by the patient) to determine telogen and anagen counts, or structural hair shaft abnormality","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99152","name":"Mod sed same phys/qhp 5/>yrs","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93662","name":"Intracardiac ecg (ice)","description":"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85230","name":"Clot factor vii proconvertin","description":"Clotting; factor vii (proconvertin, stable factor)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44721","name":"Prep donor intestine/artery","description":"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; arterial anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3000.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33427","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2121.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40840","name":"Reconstruction of mouth","description":"Vestibuloplasty; anterior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81020","name":"Urinalysis glass test","description":"Urinalysis; 2 or 3 glass test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4146.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93298","name":"Rem interrog dev eval scrms","description":"Interrogation device evaluation(s), (remote) up to 30 days; subcutaneous cardiac rhythm monitor system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28270","name":"Release of foot contracture","description":"Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93619","name":"Comprehensive ep evaluation","description":"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94727","name":"Gas dil/wshot deter lng vol","description":"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96151","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A7042","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83008","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94642","name":"Aerosol inhalation treatment","description":"Aerosol inhalation of pentamidine for pneumocystis carinii pneumonia treatment or prophylaxis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50433","name":"Plmt nephroureteral catheter","description":"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74301","name":"X-rays at surgery add-on","description":"Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33536","name":"Cabg arterial four or more","description":"Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2297.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47552","name":"Biliary endo perq dx w/speci","description":"Biliary endoscopy, percutaneous via t-tube or other tract; diagnostic, with collection of specimen(s) by brushing and/or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5546.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26358","name":"Repair/graft hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); secondary, with free graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35011","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, axillary-brachial artery, by arm incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35246","name":"Rpr blvsl vn grf ntrthrc w/o","description":"Repair blood vessel with vein graft; intrathoracic, without bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48400","name":"Injection intraop add-on","description":"Injection procedure for intraoperative pancreatography (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78832","name":"Rp loclzj tum spect w/ct 2","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"R0075","name":"Transport port x-ray multipl","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99486","name":"Suprv interfac trnsport addl","description":"Supervision by a control physician of interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with transport team before transport, at the referring facility and during the transport, including data inter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89160","name":"Exam feces for meat fibers","description":"Meat fibers, feces","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22861","name":"Rev rplcm arthrp 1ntrspc crv","description":"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2126.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65260","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65420","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","name":"Anes px ear w/bx nos","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99472","name":"Ped critical care subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64644","name":"Chemodenerv 1 extrem 5/> mus","description":"Chemodenervation of one extremity; 5 or more muscles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78459","name":"Myocrd img pet single study","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31582","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1407.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24635","name":"Optx monteggia fx dislc elbw","description":"Open treatment of monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2931.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36010","name":"Place catheter in vein","description":"Introduction of catheter, superior or inferior vena cava","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2862.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83992","name":"Assay for phencyclidine","description":"Phencyclidine (pcp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64788","name":"Remove skin nerve lesion","description":"Excision of neurofibroma or neurolemmoma; cutaneous nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28475","name":"Cltx metatarsal fx w/mnpj ea","description":"Closed treatment of metatarsal fracture; with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46083","name":"Inc thrombosed hroid xtrnl","description":"Incision of thrombosed hemorrhoid, external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42182","name":"Repair palate","description":"Repair, laceration of palate; over 2 cm or complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2276.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25215","name":"Removal of wrist bones","description":"Carpectomy; all bones of proximal row","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72114","name":"X-ray exam l-s spine bending","description":"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96125","name":"Cognitive test by hc pro","description":"Standardized cognitive performance testing (eg, ross information processing assessment) per hour of a qualified health care professionals time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78708","name":"K flow/funct image w/drug","description":"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96125","name":"Cognitive test by hc pro","description":"Standardized cognitive performance testing (eg, ross information processing assessment) per hour of a qualified health care professionals time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67316","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24635","name":"Optx monteggia fx dislc elbw","description":"Open treatment of monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25400","name":"Repair radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; without graft (eg, compression technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34001","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; carotid, subclavian or innominate artery, by neck incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27600","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; anterior and/or lateral compartments only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27600","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; anterior and/or lateral compartments only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64413","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87015","name":"Specimen infect agnt concntj","description":"Concentration (any type), for infectious agents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0181","name":"Home health care supervision","description":"Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28054","name":"Biopsy of toe joint lining","description":"Arthrotomy with biopsy; interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44721","name":"Prep donor intestine/artery","description":"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; arterial anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80417","name":"Renin stimulation panel","description":"Peripheral vein renin stimulation panel (eg, captopril) this panel must include the following: renin (84244 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67974","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01484","name":"Anes opn lw l/a/f oste/ostpl","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43249","name":"Esoph egd dilation <30 mm","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67935","name":"Repair eyelid wound","description":"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72082","name":"X-ray exam entire spi 2/3 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84160","name":"Assay of protein any source","description":"Protein, total, by refractometry, any source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76150","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27067","name":"Remove/graft hip bone lesion","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; with autograft requiring separate incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5925.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82627","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone-sulfate (dhea-s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83935","name":"Assay of urine osmolality","description":"Osmolality; urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33973","name":"Insert balloon device","description":"Insertion of intra-aortic balloon assist device through the ascending aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0325","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35005","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, vertebral artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93621","name":"Comp ep evl l pac&rec c sins","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45500","name":"Repair of rectum","description":"Proctoplasty; for stenosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36147","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26510","name":"Thumb tendon transfer","description":"Cross intrinsic transfer, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27246","name":"Treat thigh fracture","description":"Closed treatment of greater trochanteric fracture, without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","name":"Anes hrna rpr lmbr&vnt&/dehs","description":"Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":15.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64486","name":"Tap block unil by injection","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72159","name":"Mr angio spine w/o&w/dye","description":"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53060","name":"Drainage of urethra abscess","description":"Drainage of skenes gland abscess or cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","QB","NU","QF","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","name":"Anes px art knee&pop teaec","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31395","name":"Reconstruct larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; with reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2241.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0181","name":"Home health care supervision","description":"Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21452","name":"Perq tx mndblr fx xtrnl fixj","description":"Percutaneous treatment of mandibular fracture, with external fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71552","name":"Mri chest w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64680","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3619.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35303","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; popliteal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1089.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64645","name":"Chemodenerv 1 extrem 5/> ea","description":"Chemodenervation of one extremity; each additional extremity, 5 or more muscles (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35013","name":"Repair artery rupture arm","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, axillary-brachial artery, by arm incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1108.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0101","name":"Ca screen;pelvic/breast exam","description":"Cervical or vaginal cancer screening; pelvic and clinical breast examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4298.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3102.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28495","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"Patient recorded spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; includes reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibration and review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94453","name":"Hast w/suppl oxygen titrj","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27236","name":"Treat thigh fracture","description":"Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57531","name":"Removal of cervix radical","description":"Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1248.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92242","name":"Fluorescein&icg angiography","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20805","name":"Replant forearm complete","description":"Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2782.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26356","name":"Repair finger/hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); primary, without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43773","name":"Lap replace gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58571","name":"Tlh w/t/o 250 g or less","description":"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85670","name":"Thrombin time plasma","description":"Thrombin time; plasma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52343","name":"Cysto w/renal stricture tx","description":"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26850","name":"Fusion of knuckle","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83918","name":"Organic acids total quant","description":"Organic acids; total, quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92538","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28420","name":"Optx calcaneal fx w/bone grf","description":"Open treatment of calcaneal fracture, includes internal fixation, when performed; with primary iliac or other autogenous bone graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60500","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1380.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27258","name":"Treat hip dislocation","description":"Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93460","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64886","name":"Nerve graft head/neck >4 cm","description":"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":52.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32663","name":"Thoracoscopy w/lobectomy","description":"Thoracoscopy, surgical; with lobectomy (single lobe)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35112","name":"Repair artery rupture spleen","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, splenic artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65260","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54440","name":"Repair of penis","description":"Plastic operation of penis for injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29046","name":"Appl bdy cst sho to hip b th","description":"Application of body cast, shoulder to hips; including both thighs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37200","name":"Transcatheter biopsy","description":"Transcatheter biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27640","name":"Partial removal of tibia","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1892.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49426","name":"Revise abdomen-venous shunt","description":"Revision of peritoneal-venous shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25492","name":"Prophylactic tx radius&ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius and ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","name":"Tumor immunohistochem/manual","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7679.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77768","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6306.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","name":"Anes px hrt w/pump age 1yr+","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43273","name":"Endoscopic pancreatoscopy","description":"Endoscopic cannulation of papilla with direct visualization of pancreatic/common bile duct(s) (list separately in addition to code(s) for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49180","name":"Biopsy abdominal mass","description":"Biopsy, abdominal or retroperitoneal mass, percutaneous needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2780.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69955","name":"Release facial nerve","description":"Total facial nerve decompression and/or repair (may include graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1596.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0448T","name":"Remvl insj impltbl gluc sens","description":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor, including system activation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4927","name":"Non-sterile gloves","description":"Gloves, non-sterile, per 100","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50630","name":"Removal of ureter stone","description":"Ureterolithotomy; lower one-third of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69645","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86765","name":"Rubeola antibody","description":"Antibody; rubeola","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64822","name":"Sympathectomy ulnar artery","description":"Sympathectomy; ulnar artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15822","name":"Blepharoplasty upper eyelid","description":"Blepharoplasty, upper eyelid;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27780","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35013","name":"Repair artery rupture arm","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, axillary-brachial artery, by arm incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1108.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26034","name":"Treat hand bone lesion","description":"Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61592","name":"Orbitocranial approach/skull","description":"Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural elevation of temporal lobe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2863.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25695","name":"Optx lunate dislocation","description":"Open treatment of lunate dislocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":54.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82800","name":"Blood ph","description":"Gases, blood, ph only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54410","name":"Remove/replace penis prosth","description":"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93724","name":"Elec alys antitchycar pm sys","description":"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54110","name":"Treatment of penis lesion","description":"Excision of penile plaque (peyronie disease);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27882","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula; open, circular (guillotine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87427","name":"Shiga-like toxin ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; shiga-like toxin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93654","name":"Compre ep eval tx vt","description":"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording and catheter ablation of arrhythmogenic focus, including intracardiac electrophysiologic 3-dimensiona","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99340","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50574","name":"Kidney endoscopy & biopsy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51580","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64476","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88387","name":"Macroscopic xm dsj&prep tiss","description":"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54230","name":"Njx corpora cavernosograpy","description":"Injection procedure for corpora cavernosography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92583","name":"Select picture audiometry","description":"Select picture audiometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25024","name":"Decompress forearm 2 spaces","description":"Decompression fasciotomy, forearm and/or wrist, flexor and extensor compartment; without debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0710","name":"Restraints any type","description":"Restraints, any type (body, chest, wrist or ankle)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44141","name":"Partial removal of colon","description":"Colectomy, partial; with skin level cecostomy or colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1509.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87498","name":"Enterovirus probe&revrs trns","description":"Infectious agent detection by nucleic acid (dna or rna); enterovirus, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28322","name":"Repair of metatarsals","description":"Repair, nonunion or malunion; metatarsal, with or without bone graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34718","name":"Evasc rpr n/a a-iliac ndgft","description":"Endovascular repair of iliac artery, not associated with placement of an aorto-iliac artery endograft at the same session, by deployment of an iliac branched endograft, including pre-procedure sizing and device selection, all ipsilateral selective iliac artery catheterization(s), all associated radi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27648","name":"Injection for ankle x-ray","description":"Injection procedure for ankle arthrography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30520","name":"Repair of nasal septum","description":"Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27047","name":"Exc hip/pelvis les sc < 3 cm","description":"Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33767","name":"Shunt supr v/c p-art bth lng","description":"Shunt; superior vena cava to pulmonary artery for flow to both lungs (bidirectional glenn procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1234.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27279","name":"Arthrd si jt plmt tartclr dv","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of transarticular device(s) and/or intra-articular device(s) piercing the lateral or medial cortices of the ilium and the lateral cortex of the ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2352.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96168","name":"Hlth bhv ivntj fam ea addl","description":"Health behavior intervention, family (with the patient present), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2525.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403T","name":"Diabetes prev standard curr","description":"Preventive behavior change, intensive program of prevention of diabetes using a standardized diabetes prevention program curriculum, provided to individuals in a group setting, minimum 60 minutes, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81171","name":"Aff2 gen aly detc abnl allel","description":"Aff2 (alf transcription elongation factor 2 [fmr2]) (eg, fragile x intellectual disability 2 [fraxe]) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44680","name":"Surgical revision intestine","description":"Intestinal plication (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56821","name":"Colposcopy vulva w/biopsy","description":"Colposcopy of the vulva; with biopsy(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","AU","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2794.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82726","name":"Long chain fatty acids","description":"Very long chain fatty acids","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95950","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88121","name":"Cytp urine 3-5 probes cmptr","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43848","name":"Revj open gstr rstcv px","description":"Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1621.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36216","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4159","name":"Ef ped complete soy based","description":"Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96152","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23700","name":"Mnpj anes sho jt fixj aprats","description":"Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58575","name":"Laps tot hyst resj mal","description":"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27202","name":"Treat tail bone fracture","description":"Open treatment of coccygeal fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88350","name":"Imfluor ea addl 1antb stn px","description":"Immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KF","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32442","name":"Sleeve pneumonectomy","description":"Removal of lung, pneumonectomy; with resection of segment of trachea followed by broncho-tracheal anastomosis (sleeve pneumonectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2461.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69220","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73523","name":"X-ray exam hips bi 5/> views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27769","name":"Optx post ankle fx","description":"Open treatment of posterior malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01130","name":"Anes body cast appl/revj","description":"Anesthesia for body cast application or revision","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22903","name":"Exc abd les sc 3 cm/>","description":"Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2826.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59410","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82810","name":"Blood gases o2 sat only","description":"Gases, blood, o2 saturation only, by direct measurement, except pulse oximetry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83033","name":"Hemoglobin ftl f assay qual","description":"Hemoglobin; f (fetal), qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65272","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11307","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20702","name":"Mnl prep&insj imed rx dev","description":"Manual preparation and insertion of drug-delivery device(s), intramedullary (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42970","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or without anterior packs and/or cautery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44900","name":"I&d appendix abscess open","description":"Incision and drainage of appendiceal abscess, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92314","name":"C-lens fitg tech ou","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens, both eyes except for aphakia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11921","name":"Correct skn color 6.1-20.0cm","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.1 to 20.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22585","name":"Arthrd ant ntrbd min dsc ea","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47539","name":"Perq plmt bile duct stent","description":"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; new access,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76350","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72157","name":"Mri chest spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":448.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93623","name":"Prgrmd stimj&pacg iv rx nfs","description":"Programmed stimulation and pacing after intravenous drug infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","name":"Anes opn/arthr px sho jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24079","name":"Rad rescj tum tiss a/e 5 cm+","description":"Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27562","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44110","name":"Excise intestine lesion(s)","description":"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64415","name":"Njx aa&/strd brch plxs img","description":"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63191","name":"Incise spine accessory nerve","description":"Laminectomy with section of spinal accessory nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1255.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37236","name":"Open/perq place stent 1st","description":"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"UNK","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4270.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42227","name":"Lengthening of palate","description":"Lengthening of palate, with island flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15825","name":"Rhytdct nck pltysml tghtg","description":"Rhytidectomy; neck with platysmal tightening (platysmal flap, p-flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29015","name":"Appl rissr jacket bdy w/head","description":"Application of risser jacket, localizer, body; including head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11471","name":"Exc skn h/p/p/u complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with complex repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E8000","name":"Posterior gait trainer","description":"Gait trainer, pediatric size, posterior support, includes all accessories and components","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44680","name":"Surgical revision intestine","description":"Intestinal plication (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","name":"Anes cardiac catheterization","description":"Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include swan-ganz catheter)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82656","name":"El-1 fecal qual/semiq","description":"Elastase, pancreatic (el-1), fecal; qualitative or semi-quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33273","name":"Repos prev impltbl subq dfb","description":"Repositioning of previously implanted subcutaneous implantable defibrillator electrode","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49580","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26034","name":"Treat hand bone lesion","description":"Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33665","name":"Repair of heart defects","description":"Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1665.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32096","name":"Open wedge/bx lung infiltr","description":"Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49419","name":"Insert tun ip cath w/port","description":"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69320","name":"Rebuild outer ear canal","description":"Reconstruction external auditory canal for congenital atresia, single stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71275","name":"Ct angiography chest","description":"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1748.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27508","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92524","name":"Behavral qualit analys voice","description":"Behavioral and qualitative analysis of voice and resonance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44604","name":"Suture large intestine","description":"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58952","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction, intra-abdominal or retroperitoneal tumors)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1039.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62000","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; simple, extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21125","name":"Augmentation mndblr prostc","description":"Augmentation, mandibular body or angle; prosthetic material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31267","name":"Endoscopy maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87290","name":"Varicella zoster ag if","description":"Infectious agent antigen detection by immunofluorescent technique; varicella zoster virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["AW","GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5183.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7671.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54385","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter; with incontinence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2039.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33986","name":"Ecmo/ecls rmvl ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, 6 years and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95806","name":"Sleep study unatt&resp efft","description":"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44385","name":"Endoscopy of bowel pouch","description":"Endoscopic evaluation of small intestinal pouch (eg, kock pouch, ileal reservoir [s or j]); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36584","name":"Compl rplcmt picc rs&i","description":"Replacement, complete, of a peripherally inserted central venous catheter (picc), without subcutaneous port or pump, through same venous access, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24930","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; re-amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44800","name":"Excision of bowel pouch","description":"Excision of meckels diverticulum (diverticulectomy) or omphalomesenteric duct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35697","name":"Reimplant artery each","description":"Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28496","name":"Treat big toe fracture","description":"Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0281","name":"Elec stim unattend for press","description":"Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38562","name":"Removal pelvic lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43260","name":"Ercp w/specimen collection","description":"Endoscopic retrograde cholangiopancreatography (ercp); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57308","name":"Fistula repair transperine","description":"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28981.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1732.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":702.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94668","name":"Mnpj chest wall sbsq","description":"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5069.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35190","name":"Repair acq av fistula xtr","description":"Repair, acquired or traumatic arteriovenous fistula; extremities","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66825","name":"Reposition intraocular lens","description":"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58900","name":"Biopsy of ovary(s)","description":"Biopsy of ovary, unilateral or bilateral (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37213","name":"Thromblytic art/ven therapy","description":"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35311","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; subclavian, innominate, by thoracic incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37226","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5007.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27752","name":"Treatment of tibia fracture","description":"Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31075","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, lynch type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33300","name":"Repair of heart wound","description":"Repair of cardiac wound; without bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96913","name":"Photochemotx sev dermatoses","description":"Photochemotherapy (goeckerman and/or puva) for severe photoresponsive dermatoses requiring at least 4-8 hours of care under direct supervision of the physician (includes application of medication and dressings)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43312","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1324.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64787","name":"Implant nerve end","description":"Implantation of nerve end into bone or muscle (list separately in addition to neuroma excision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1500.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1853.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99423","name":"Ol dig e/m svc 21+ min","description":"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78803","name":"Rp loclzj tum spect 1 area","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61304","name":"Crnec/crnot expl supratntorl","description":"Craniectomy or craniotomy, exploratory; supratentorial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93650","name":"Icar cath abltj av node func","description":"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4262","name":"Temporary tear duct plug","description":"Temporary, absorbable lacrimal duct implant, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95251","name":"Cont gluc mntr analysis i&r","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93591","name":"Perq transcath cls aortic","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01470","name":"Anes px nrv msc lw l/a/f nos","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57200","name":"Repair of vagina","description":"Colporrhaphy, suture of injury of vagina (nonobstetrical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33880","name":"Evasc rpr ta ndgft cov lsa","description":"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment of an aorto-aortic tube endograft covering the left subclavian artery and all aortic tube endograft e","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1568.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70554","name":"Fmri brain by tech","description":"Magnetic resonance imaging, brain, functional mri; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP03","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","name":"Anes nrv msc upr a&e tndsis","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83661","name":"L/s ratio fetal lung","description":"Fetal lung maturity assessment; lecithin sphingomyelin (l/s) ratio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50040","name":"Nfros nfrot w/drg","description":"Nephrostomy, nephrotomy with drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15835","name":"Exc excessive skin buttock","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86870","name":"Rbc antibody identification","description":"Antibody identification, rbc antibodies, each panel for each serum technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30802","name":"Ablate inf turbinate submuc","description":"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (ie, submucosal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9187","name":"Bpci home visit","description":"Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/managemen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1815","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67010","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72141","name":"Mri neck spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27125","name":"Partial hip replacement","description":"Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11770","name":"Exc pilonidal cyst simple","description":"Excision of pilonidal cyst or sinus; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21554","name":"Exc neck tum deep 5 cm/>","description":"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70492","name":"Ct sft tsue nck w/o & w/dye","description":"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358T","name":"Bia whole body","description":"Bioelectrical impedance analysis whole body composition assessment, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6491.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76102","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93893","name":"Tcd std icr art ven-art shnt","description":"Transcranial doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2975.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32320","name":"Free/remove chest lining","description":"Decortication and parietal pleurectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1275.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27725","name":"Repair of lower leg","description":"Repair of nonunion or malunion, tibia; by synostosis, with fibula, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61000","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99153","name":"Mod sed same phys/qhp ea","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81237","name":"Ezh2 gene common variants","description":"Ezh2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large b-cell lymphoma) gene analysis, common variant(s) (eg, codon 646)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45402","name":"Lap proctopexy w/sig resect","description":"Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27888","name":"Amputation of foot at ankle","description":"Amputation, ankle, through malleoli of tibia and fibula (eg, syme, pirogoff type procedures), with plastic closure and resection of nerves","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31527","name":"Laryngoscopy for treatment","description":"Laryngoscopy direct, with or without tracheoscopy; with insertion of obturator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50575","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67900","name":"Repair brow defect","description":"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59856","name":"Induced ab 1+vag supp d&c","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27059","name":"Resect hip/pelv tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44850","name":"Repair of mesentery","description":"Suture of mesentery (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25078","name":"Resect forarm/wrist tum 3cm>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49419","name":"Insert tun ip cath w/port","description":"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24498","name":"Proph tx w/wo mthylmthcrylt","description":"Prophylactic treatment (nailing, pinning, plating or wiring), with or without methylmethacrylate, humeral shaft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","name":"Anes open px lower l/a/f nos","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26535","name":"Revise finger joint","description":"Arthroplasty, interphalangeal joint; each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87481","name":"Candida dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77370","name":"Radiation physics consult","description":"Special medical radiation physics consultation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77435","name":"Sbrt management","description":"Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24900","name":"Amputation of upper arm","description":"Amputation, arm through humerus; with primary closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27517","name":"Treat thigh fx growth plate","description":"Closed treatment of distal femoral epiphyseal separation; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","name":"Anes art f/arm wrst&hnd nos","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","name":"Anes px vn upr arm&elbw nos","description":"Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31390","name":"Removal of larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; without reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2126.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86777","name":"Toxoplasma antibody","description":"Antibody; toxoplasma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","name":"Anes rad amp pns ingun&ilac","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49651","name":"Lap ing hernia repair recur","description":"Laparoscopy, surgical; repair recurrent inguinal hernia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31588","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01232","name":"Anes opn px upr 2/3 fem amp","description":"Anesthesia for open procedures involving upper two-thirds of femur; amputation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15277","name":"Skn sub grft f/n/hf/g child","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0249","name":"Provide inr test mater/equip","description":"Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86611","name":"Bartonella antibody","description":"Antibody; bartonella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient compression arm sleeve and glove combination, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83690","name":"Assay of lipase","description":"Lipase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64911","name":"Neurorraphy w/vein autograft","description":"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87102","name":"Fungus isolation culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25280","name":"Revise wrist/forearm tendon","description":"Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86625","name":"Campylobacter antibody","description":"Antibody; campylobacter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37233","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73503","name":"X-ray exam hip uni 4/> views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84163","name":"Pappa serum","description":"Pregnancy-associated plasma protein-a (papp-a)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19305","name":"Mast radical","description":"Mastectomy, radical, including pectoral muscles, axillary lymph nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33915","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1194.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4810.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]},{"negotiated_type":"negotiated","negotiated_rate":2534.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77300","name":"Radiation therapy dose plan","description":"Basic radiation dosimetry calculation, central axis depth dose calculation, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33935","name":"Transplantation heart/lung","description":"Heart-lung transplant with recipient cardiectomy-pneumonectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4330.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24365","name":"Reconstruct head of radius","description":"Arthroplasty, radial head;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27687","name":"Revision of calf tendon","description":"Gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88329","name":"Path consltj drg surg","description":"Pathology consultation during surgery;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4997.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75989","name":"Abscess drainage under x-ray","description":"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82378","name":"Carcinoembryonic antigen","description":"Carcinoembryonic antigen (cea)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45355","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2333.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2275.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93533","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96405","name":"Chemo intralesional up to 7","description":"Chemotherapy administration; intralesional, up to and including 7 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45400","name":"Laparoscopic proc","description":"Laparoscopy, surgical; proctopexy (for prolapse)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86334","name":"Immunofix e-phoresis serum","description":"Immunofixation electrophoresis; serum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4057.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93457","name":"R hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26125","name":"Release palm contracture","description":"Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft); each additional digit (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20822","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes distal tip to sublimis tendon insertion), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1503.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99219","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44300","name":"Open bowel to skin","description":"Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5339.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"Off/op consltj new/est sf 20","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37248","name":"Trluml balo angiop 1st vein","description":"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76950","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29848","name":"Wrist endoscopy/surgery","description":"Endoscopy, wrist, surgical, with release of transverse carpal ligament","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42665","name":"Ligation of salivary duct","description":"Ligation salivary duct, intraoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2456.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63275","name":"Bx/exc xdrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1638.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50785","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with vesico-psoas hitch or bladder flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"S3818","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1275.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26373","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; secondary without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84488","name":"Test feces for trypsin","description":"Trypsin; feces, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99487","name":"Cplx chrnc care 1st 60 min","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27110","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to greater trochanter of femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4575","name":"Hyperbaric o2 chamber disps","description":"Topical hyperbaric oxygen chamber, disposable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0400","name":"Home sleep test/type 4 porta","description":"Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1565.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41150","name":"Tongue mouth jaw surgery","description":"Glossectomy; composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85244","name":"Clot factor viii reltd antgn","description":"Clotting; factor viii related antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54417","name":"Remv/replc penis pros compl","description":"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01230","name":"Anes opn upper 2/3 femur nos","description":"Anesthesia for open procedures involving upper two-thirds of femur; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78478","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95165","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of doses)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","name":"Anes ivntl rad artl crtd/c","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69840","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47620","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1155.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1366.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64632","name":"N block inj common digit","description":"Destruction by neurolytic agent; plantar common digital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63043","name":"Laminotomy addl cervical","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional cervical interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24538","name":"Prq skel fix sprcndlr hum fx","description":"Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2708.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45320","name":"Proctosigmoidoscopy ablate","description":"Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (eg, laser)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3249.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2809.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36245","name":"Ins cath abd/l-ext art 1st","description":"Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96136","name":"Psycl/nrpsyc tst phy/qhp 1st","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53240","name":"Surgery for urethra pouch","description":"Marsupialization of urethral diverticulum, male or female","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22633","name":"Arthrd cmbn 1ntrspc lumbar","description":"Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1642.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27178","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; closed manipulation with single or multiple pinning","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83789","name":"Mass spectrometry qual/quan","description":"Mass spectrometry and tandem mass spectrometry (eg, ms, ms/ms, maldi, ms-tof, qtof), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87420","name":"Resp syncytial virus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; respiratory syncytial virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24516","name":"Tx humrl shaft fx imed implt","description":"Treatment of humeral shaft fracture, with insertion of intramedullary implant, with or without cerclage and/or locking screws","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26170","name":"Removal of palm tendon each","description":"Excision of tendon, palm, flexor or extensor, single, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93508","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17110","name":"Destruction b9 les up to 14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21208","name":"Augmentation of facial bones","description":"Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1370.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34714","name":"Opn fem art expos cndt crtj","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518T","name":"Rmvl pg wcs lv battery only","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; battery component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33214","name":"Upgrade of pacemaker system","description":"Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43333","name":"Transab esoph hiat hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1995.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47721","name":"Fuse upper gi structures","description":"Cholecystoenterostomy; with gastroenterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55540","name":"Revise hernia & sperm veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","name":"Anes upr lwr gi ndsc px","description":"Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43196","name":"Esophagoscp guide wire dilat","description":"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86735","name":"Mumps antibody","description":"Antibody; mumps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80103","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27284","name":"Arthrodesis hip joint","description":"Arthrodesis, hip joint (including obtaining graft);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58180","name":"Partial hysterectomy","description":"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21344","name":"Open tx compl front sinus fx","description":"Open treatment of complicated (eg, comminuted or involving posterior wall) frontal sinus fracture, via coronal or multiple approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55810","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70543","name":"Mri orbt/fac/nck w/o &w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24566","name":"Prq skel fix epcndylr hum fx","description":"Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95724","name":"Eeg phy/qhp>60<84 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 60 hours, up to 84 hours of eeg recording, with video (veeg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34203","name":"Removal of leg artery clot","description":"Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88155","name":"Cytopath c/v index add-on","description":"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (list separately in addition to code[s] for other technical and interpretation services)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88241","name":"Frozen cell preparation","description":"Thawing and expansion of frozen cells, each aliquot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99337","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5049.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31541","name":"Larynscop w/tumr exc + scope","description":"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26916.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11732","name":"Avlsn nail plate simple each","description":"Avulsion of nail plate, partial or complete, simple; each additional nail plate (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64740","name":"Incision of tongue nerve","description":"Transection or avulsion of; lingual nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44210","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1423.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43261","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55060","name":"Repair of hydrocele","description":"Repair of tunica vaginalis hydrocele (bottle type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46275","name":"Remove anal fist inter","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41800","name":"Drainage of gum lesion","description":"Drainage of abscess, cyst, hematoma from dentoalveolar structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","name":"Anes open total ankle rplcmt","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81333","name":"Tgfbi gene common variants","description":"Tgfbi (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, r124h, r124c, r124l, r555w, r555q)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10970.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37211","name":"Thrombolytic art therapy","description":"Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1097.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89320","name":"Semen anal vol/count/mot","description":"Semen analysis; volume, count, motility, and differential","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29131","name":"Appl finger splint dynamic","description":"Application of finger splint; dynamic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20920","name":"Removal of fascia for graft","description":"Fascia lata graft; by stripper","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62272","name":"Ther spi pnxr drg csf","description":"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2092.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51710","name":"Change of bladder tube","description":"Change of cystostomy tube; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64508","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96570","name":"Photodynmc tx 30 min add-on","description":"Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (list separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","name":"Anes iper upr abd gstr px mo","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0276","name":"Pild/placebo control clin tr","description":"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66983","name":"Cataract surg w/iol 1 stage","description":"Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94004","name":"Vent mgmt nf per day","description":"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; nursing facility, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0425","name":"Inpt/ed teleconsult30","description":"Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49600","name":"Repair umbilical lesion","description":"Repair of small omphalocele, with primary closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23575","name":"Cltx scap fx w/mnpj +-tractj","description":"Closed treatment of scapular fracture; with manipulation, with or without skeletal traction (with or without shoulder joint involvement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81165","name":"Brca1 gene full seq alys","description":"Brca1 (brca1, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6008","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75791","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87106","name":"Fungi identification yeast","description":"Culture, fungi, definitive identification, each organism; yeast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23145","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4036","name":"Enteral feed sup kit grav by","description":"Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33362","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open femoral artery approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96521","name":"Refill/maint portable pump","description":"Refilling and maintenance of portable pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93286","name":"Peri-px eval pm/ldls pm ip","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead pacemaker system, or leadless pacemaker ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1049.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92015","name":"Determine refractive state","description":"Determination of refractive state","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3735.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28035","name":"Decompression of tibia nerve","description":"Release, tarsal tunnel (posterior tibial nerve decompression)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"Home/res vst est low mdm 30","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25608","name":"Optx dst rd xart fx/epi sep2","description":"Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 2 fragments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33418","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1556.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83908","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92516","name":"Facial nerve function test","description":"Facial nerve function studies (eg, electroneuronography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2789.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77058","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29550","name":"Strapping of toes","description":"Strapping; toes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3455.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KF","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78708","name":"K flow/funct image w/drug","description":"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50205","name":"Renal bx surg exposure kdn","description":"Renal biopsy; by surgical exposure of kidney","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25535","name":"Cltx ulnar shft fx w/mnpj","description":"Closed treatment of ulnar shaft fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84410","name":"Testosterone bioavailable","description":"Testosterone; bioavailable, direct measurement (eg, differential precipitation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43651","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, truncal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61559","name":"Excision of skull/sutures","description":"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining grafts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2193.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1548.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","name":"Anes dx/ther nrv blk&inj oth","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75790","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87661","name":"Trichomonas vaginalis amplif","description":"Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74245","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96368","name":"Ther/diag concurrent inf","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57540","name":"Removal of residual cervix","description":"Excision of cervical stump, abdominal approach;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24200","name":"Rmvl fb upper arm/elbw subq","description":"Removal of foreign body, upper arm or elbow area; subcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83894","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58322","name":"Artificial insemination","description":"Artificial insemination; intra-uterine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12032","name":"Intmd rpr s/a/t/ext 2.6-7.5","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96020","name":"Functional brain mapping","description":"Neurofunctional testing selection and administration during noninvasive imaging functional brain mapping, with test administered entirely by a physician or other qualified health care professional (ie, psychologist), with review of test results and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1020.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4627","name":"Spacer bag/reservoir","description":"Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99467","name":"Ped crit care transport addl","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1707.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56405","name":"I&d vulva/perineal abscess","description":"Incision and drainage of vulva or perineal abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30100","name":"Intranasal biopsy","description":"Biopsy, intranasal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35642","name":"Bpg carotid-vertebral","description":"Bypass graft, with other than vein; carotid-vertebral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47780","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20824","name":"Replantation thumb complete","description":"Replantation, thumb (includes carpometacarpal joint to mp joint), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75564","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73221","name":"Mri joint upr extrem w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88267","name":"Chromosome analys placenta","description":"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0086","name":"Care man home care plan 30 m","description":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75984","name":"Xray control catheter change","description":"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92933","name":"Prq trlml c athrc st angiop1","description":"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25000","name":"Incision of tendon sheath","description":"Incision, extensor tendon sheath, wrist (eg, de quervains disease)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58356","name":"Endometrial cryoablation","description":"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25600","name":"Cltx dst rdl fx/ephys sep wo","description":"Closed treatment of distal radial fracture (eg, colles or smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77469","name":"Io radiation tx management","description":"Intraoperative radiation treatment management","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26492","name":"Tendon transfer with graft","description":"Opponensplasty; tendon transfer with graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34803","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1097.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","53"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23330","name":"Remove shoulder foreign body","description":"Removal of foreign body, shoulder; subcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24357","name":"Repair elbow perc","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86147","name":"Cardiolipin antibody ea ig","description":"Cardiolipin (phospholipid) antibody, each ig class","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50400","name":"Revision of kidney/ureter","description":"Pyeloplasty (foley y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43211","name":"Esophagoscop mucosal resect","description":"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11450","name":"Exc skn hdrdnt ax smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or intermediate repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58110","name":"Bx done w/colposcopy add-on","description":"Endometrial sampling (biopsy) performed in conjunction with colposcopy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44314","name":"Revision of ileostomy","description":"Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1887","name":"Catheter, guiding","description":"Catheter, guiding (may include infusion/perfusion capability)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26593","name":"Release muscles of hand","description":"Release, intrinsic muscles of hand, each muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44145","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20936","name":"Sp bone agrft local add-on","description":"Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29863","name":"Hip arthr0 w/synovectomy","description":"Arthroscopy, hip, surgical; with synovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86665","name":"Epstein-barr capsid vca","description":"Antibody; epstein-barr (eb) virus, viral capsid (vca)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63198","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1914.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70482","name":"Ct orbit/ear/fossa w/o&w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51550","name":"Partial removal of bladder","description":"Cystectomy, partial; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28002","name":"Treatment of foot infection","description":"Incision and drainage below fascia, with or without tendon sheath involvement, foot; single bursal space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53665","name":"Dilation of urethra","description":"Dilation of female urethra, general or conduction (spinal) anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35211","name":"Rpr blvsl dir ntrathrc w/byp","description":"Repair blood vessel, direct; intrathoracic, with bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57292","name":"Construct vagina with graft","description":"Construction of artificial vagina; with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4929","name":"Tourniquet for dialysis, ea","description":"Tourniquet for dialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99366","name":"Team conf w/pat by hc prof","description":"Medical team conference with interdisciplinary team of health care professionals, face-to-face with patient and/or family, 30 minutes or more, participation by nonphysician qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15821","name":"Blepharp lwr eyelid fat pad","description":"Blepharoplasty, lower eyelid; with extensive herniated fat pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1901","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19285","name":"Perq dev breast 1st us imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35645","name":"Bpg subclavian-vertebral","description":"Bypass graft, with other than vein; subclavian-vertebral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4709","name":"Acid conc sol per gallon","description":"Acid concentrate, solution, for hemodialysis, per gallon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86001","name":"Allergen specific igg","description":"Allergen specific igg quantitative or semiquantitative, each allergen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42409","name":"Drainage of salivary cyst","description":"Marsupialization of sublingual salivary cyst (ranula)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82232","name":"Assay of beta-2 protein","description":"Beta-2 microglobulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95250","name":"Cont gluc mntr phys/qhp eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professional (office) provided equipment, sensor placement, hook-up, calibration of monitor, patient training, removal of sensor, and pr","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36583","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43281","name":"Lap paraesophag hern repair","description":"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1467.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99234","name":"Hosp ip/obs sm dt sf/low 45","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34530","name":"Leg vein fusion","description":"Saphenopopliteal vein anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99116","name":"Anes comp tot bdy hypthrm","description":"Anesthesia complicated by utilization of total body hypothermia (list separately in addition to code for primary anesthesia procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73222","name":"Mri joint upr extrem w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27090","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14020","name":"Tis trnfr s/a/l 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22867","name":"Insj stablj dev w/dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24345","name":"Repr elbw med ligmnt w/tissu","description":"Repair medial collateral ligament, elbow, with local tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95873","name":"Guide nerv destr elec stim","description":"Electrical stimulation for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51820","name":"Revision of urinary tract","description":"Cystourethroplasty with unilateral or bilateral ureteroneocystostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57420","name":"Exam of vagina w/scope","description":"Colposcopy of the entire vagina, with cervix if present;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29365","name":"Appl cylinder cast","description":"Application of cylinder cast (thigh to ankle)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84379","name":"Sugars multiple quant","description":"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22526","name":"Idet single level","description":"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27335","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior and posterior including popliteal area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33512","name":"Cabg vein three","description":"Coronary artery bypass, vein only; 3 coronary venous grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2102.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76497","name":"Unlisted ct procedure","description":"Unlisted computed tomography procedure (eg, diagnostic, interventional)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20005","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86812","name":"Hla typing a b or c","description":"Hla typing; a, b, or c (eg, a10, b7, b27), single antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22102","name":"Remove part lumbar vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83505","name":"Assay total hydroxyproline","description":"Hydroxyproline; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52441","name":"Cysto insj trnsprstc 1 implt","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21195","name":"Reconst lwr jaw w/o fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92506","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66605","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; with cyclectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0398","name":"Home sleep test/type 2 porta","description":"Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22600","name":"Arthrd pst tq 1ntrspc crv","description":"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below c2 segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74230","name":"X-ray xm swlng funcj c+","description":"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24105","name":"Excision olecranon bursa","description":"Excision, olecranon bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90714","name":"Td vacc no presv 7 yrs+ im","description":"Tetanus and diphtheria toxoids adsorbed (td), preservative free, when administered to individuals 7 years or older, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33979","name":"Insert intracorporeal device","description":"Insertion of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1700.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48520","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33670","name":"Repair of heart chambers","description":"Repair of complete atrioventricular canal, with or without prosthetic valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1719.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84144","name":"Assay of progesterone","description":"Progesterone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27386","name":"Repair/graft of thigh muscle","description":"Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37185","name":"Prim art m-thrmbc sbsq vsl","description":"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); second and all subsequent vessel(s) within the same vascular family (list separa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31526","name":"Dx laryngoscopy w/oper scope","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93924","name":"Lwr xtr vasc stdy bilat","description":"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a st","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","KM","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88309","name":"Tissue exam by pathologist","description":"Level vi - surgical pathology, gross and microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection extremity, disarticulation fetus, with dissection larynx, partial/total resect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78710","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","name":"Anes dx/ther nrv blk&inj prn","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84578","name":"Test urine urobilinogen","description":"Urobilinogen, urine; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74240","name":"X-ray xm upr gi trc 1cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78430","name":"Myocrd img pet rst/strs w/ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51728","name":"Cystometrogram w/vp","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94240","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31540","name":"Laryngoscopy w/exc of tumor","description":"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89310","name":"Semen analysis w/count","description":"Semen analysis; motility and count (not including huhner test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33845","name":"Excision coa w/graft","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1154.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75571","name":"Ct hrt w/o dye w/ca test","description":"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41805","name":"Removal foreign body gum","description":"Removal of embedded foreign body from dentoalveolar structures; soft tissues","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28600","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27232","name":"Treat thigh fracture","description":"Closed treatment of femoral fracture, proximal end, neck; with manipulation, with or without skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42802","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00934","name":"Anes rad amp penis ingun lym","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25394","name":"Repair carpal bone shorten","description":"Osteoplasty, carpal bone, shortening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85705","name":"Thromboplastin inhibition","description":"Thromboplastin inhibition, tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62302","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19340","name":"Insj breast implt sm d mast","description":"Insertion of breast implant on same day of mastectomy (ie, immediate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43101","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21346","name":"Opn tx nasomax fx w/fixj","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); with wiring and/or local fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87530","name":"Hsv dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92640","name":"Aud brainstem implt programg","description":"Diagnostic analysis with programming of auditory brainstem implant, per hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0869","name":"Pwc gp 4 std cap chair","description":"Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4564.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4164","name":"Parenteral 50% dextrose solu","description":"Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27215","name":"Treat pelvic fracture(s)","description":"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral, for pelvic bone fracture patterns that do not disrupt the pelvic ring, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64413","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49570","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45562","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24138","name":"Sequestrectomy olecrn proces","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3617.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]},{"negotiated_type":"negotiated","negotiated_rate":1906.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21013","name":"Exc face tum deep < 2 cm","description":"Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); less than 2 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44340","name":"Revision of colostomy","description":"Revision of colostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49041","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52343","name":"Cysto w/renal stricture tx","description":"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11045","name":"Dbrdmt subq tiss each addl","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75952","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46320","name":"Removal of hemorrhoid clot","description":"Excision of thrombosed hemorrhoid, external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49587","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28310","name":"Revision of big toe","description":"Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93556","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35190","name":"Repair acq av fistula xtr","description":"Repair, acquired or traumatic arteriovenous fistula; extremities","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11644","name":"Exc f/e/e/n/l mal+mrg 3.1-4","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51729","name":"Cystometrogram w/vp&up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","name":"Anes integ sys rcnstv breast","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27781","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88177","name":"Cytp fna eval ea addl","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3230","name":"Custom shoes depth inlay","description":"Orthopedic footwear, custom shoe, depth inlay, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37246","name":"Trluml balo angiop 1st art","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38520","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90474","name":"Immune admin oral/nasal addl","description":"Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0075T","name":"Perq stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82105","name":"Alpha-fetoprotein serum","description":"Alpha-fetoprotein (afp); serum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83010","name":"Assay of haptoglobin quant","description":"Haptoglobin; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84586","name":"Assay of vip","description":"Vasoactive intestinal peptide (vip)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33016","name":"Pericardiocentesis w/imaging","description":"Pericardiocentesis, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47144","name":"Prep donor liver 3-segment","description":"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with trisegmen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31382","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); antero-latero-vertical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1584.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89060","name":"Exam synovial fluid crystals","description":"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52265","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27440","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91065","name":"Breath hydrogen/methane test","description":"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31540","name":"Laryngoscopy w/exc of tumor","description":"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]},{"negotiated_type":"negotiated","negotiated_rate":5546.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25066","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27580","name":"Fusion of knee","description":"Arthrodesis, knee, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1234.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"Office o/p new low 30 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":326.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86022","name":"Platelet antibodies","description":"Antibody identification; platelet antibodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78431","name":"Myocrd img pet rst&strs ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43194","name":"Esophagoscp rig trnso rem fb","description":"Esophagoscopy, rigid, transoral; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76930","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49323","name":"Laparo drain lymphocele","description":"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27603","name":"Drain lower leg lesion","description":"Incision and drainage, leg or ankle; deep abscess or hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6142.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63660","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0109","name":"Diab manage trn ind/group","description":"Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78588","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50435","name":"Exchange nephrostomy cath","description":"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63660","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25405","name":"Repair/graft radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95954","name":"Eeg monitoring/giving drugs","description":"Pharmacological or physical activation requiring physician or other qualified health care professional attendance during eeg recording of activation phase (eg, thiopental activation test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67922","name":"Repair eyelid defect","description":"Repair of entropion; thermocauterization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93280","name":"Pm device progr eval dual","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70559","name":"Mri brain w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36400","name":"Vnpnxr<3yrs phy/qhp fem/jug","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; femoral or jugular vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33522","name":"Cabg artery-vein five","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95950","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75561","name":"Cardiac mri for morph w/dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24566","name":"Prq skel fix epcndylr hum fx","description":"Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75562","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93556","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32482","name":"Bilobectomy","description":"Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1267.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38115","name":"Repair of ruptured spleen","description":"Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27093","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58673","name":"Laparoscopy salpingostomy","description":"Laparoscopy, surgical; with salpingostomy (salpingoneostomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86160","name":"Complement antigen","description":"Complement; antigen, each component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64454","name":"Njx aa&/strd gnclr nrv brnch","description":"Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8379.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35458","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0247","name":"Trans bench w/wo comm open","description":"Transfer bench for tub or toilet with or without commode opening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85290","name":"Clot factor xiii fibrin stab","description":"Clotting; factor xiii (fibrin stabilizing)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44180","name":"Lap enterolysis","description":"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26727","name":"Treat finger fracture each","description":"Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0047","name":"Alcohol/drug abuse svc nos","description":"Alcohol and/or other drug abuse services, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7830.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93306","name":"Tte w/doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01232","name":"Anes opn px upr 2/3 fem amp","description":"Anesthesia for open procedures involving upper two-thirds of femur; amputation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20552","name":"Njx 1/mlt trigger point 1/2","description":"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64861","name":"Repair of arm nerves","description":"Suture of; brachial plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1380.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21336","name":"Open tx septal fx w/wo stabj","description":"Open treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","name":"Anes iper upr abd pncrtect","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, whipple procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP09","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0332","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95939","name":"C motor evoked upr&lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","name":"Anes ivntl rad icr icar/aort","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or aortic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29840","name":"Wrist arthroscopy","description":"Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5706.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15278","name":"Skn sub grft f/n/hf/g ch add","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25315","name":"Revise palsy hand tendon(s)","description":"Flexor origin slide (eg, for cerebral palsy, volkmann contracture), forearm and/or wrist;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57240","name":"Anterior colporrhaphy","description":"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82163","name":"Assay of angiotensin ii","description":"Angiotensin ii","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87279","name":"Parainfluenza ag if","description":"Infectious agent antigen detection by immunofluorescent technique; parainfluenza virus, each type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21031","name":"Remove exostosis mandible","description":"Excision of torus mandibularis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27479","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); combined distal femur, proximal tibia and fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15336","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47605","name":"Cholecystectomy w/cholang","description":"Cholecystectomy; with cholangiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":939.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63273","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1706.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P7001","name":"Culture bacterial urine","description":"Culture, bacterial, urine; quantitative, sensitivity study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20920","name":"Removal of fascia for graft","description":"Fascia lata graft; by stripper","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31770","name":"Repair/graft of bronchus","description":"Bronchoplasty; graft repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69642","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33223","name":"Relocate pocket for defib","description":"Relocation of skin pocket for implantable defibrillator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38212","name":"Rbc depletion of harvest","description":"Transplant preparation of hematopoietic progenitor cells; red blood cell removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20816","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes metacarpophalangeal joint to insertion of flexor sublimis tendon), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69420","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","BA","UE","KE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4152","name":"Ef calorie dense>/=1.5kcal","description":"Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27601","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; posterior compartment(s) only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92571","name":"Filtered speech test","description":"Filtered speech test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25263","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93965","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63101","name":"Remove vert body dcmprn thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic, single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2091.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35495","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1068.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87525","name":"Hepatitis g dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","name":"Anes art f/arm wrst&hnd nos","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70481","name":"Ct orbit/ear/fossa w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83519","name":"Ria nonantibody","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, ria)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87450","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27392","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0101T","name":"Esw muscskel sys nos","description":"Extracorporeal shock wave involving musculoskeletal system, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88305","name":"Tissue exam by pathologist","description":"Level iv - surgical pathology, gross and microscopic examination abortion - spontaneous/missed artery, biopsy bone marrow, biopsy bone exostosis brain/meninges, other than for tumor resection breast, biopsy, not requiring microscopic evaluation of surgical margins breast, reduction mammoplasty bronc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86603","name":"Adenovirus antibody","description":"Antibody; adenovirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54056","name":"Cryosurgery penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92953","name":"Temporary external pacing","description":"Temporary transcutaneous pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68115","name":"Exc les conjunctiva >1 cm","description":"Excision of lesion, conjunctiva; over 1 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473T","name":"Reprgrmg io rta eltrd ra","description":"Device evaluation and interrogation of intraocular retinal electrode array (eg, retinal prosthesis), in person, including reprogramming and visual training, when performed, with review and report by a qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43775","name":"Lap sleeve gastrectomy","description":"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":939.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19000","name":"Puncture aspir cyst breast","description":"Puncture aspiration of cyst of breast;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72114","name":"X-ray exam l-s spine bending","description":"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66625","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62120","name":"Repair skull cavity lesion","description":"Repair of encephalocele, skull vault, including cranioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70480","name":"Ct orbit/ear/fossa w/o dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24305","name":"Tendon lngth upr a/e ea tdn","description":"Tendon lengthening, upper arm or elbow, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96369","name":"Sc ther infusion up to 1 hr","description":"Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); initial, up to 1 hour, including pump set-up and establishment of subcutaneous infusion site(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93237","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3306.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47532","name":"Injection for cholangiogram","description":"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26541","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with tendon or fascial graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83915","name":"Assay of nucleotidase","description":"Nucleotidase 5-","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5925.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43229","name":"Esophagoscopy lesion ablate","description":"Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12006","name":"Rpr s/n/a/gen/trk20.1-30.0cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95707","name":"Eeg w/o vid 2-12hr cont mntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, 2-12 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86335","name":"Immunfix e-phorsis/urine/csf","description":"Immunofixation electrophoresis; other fluids with concentration (eg, urine, csf)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95144","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, single dose vial(s) (specify number of vials)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15842","name":"Nerve palsy microsurg graft","description":"Graft for facial nerve paralysis; free muscle flap by microsurgical technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60505","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63077","name":"Spine disk surgery thorax","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1327.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33514","name":"Cabg vein five","description":"Coronary artery bypass, vein only; 5 coronary venous grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2274.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84378","name":"Sugars single quant","description":"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23076","name":"Exc shoulder tum deep < 5 cm","description":"Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92614","name":"Laryngoscopic sensory vid","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43453","name":"Dilate esophagus","description":"Dilation of esophagus, over guide wire","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15004","name":"Wound prep f/n/hf/g","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of bo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11951","name":"Subq njx fil matrl 1.1-5.0cc","description":"Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28820","name":"Amputation of toe","description":"Amputation, toe; metatarsophalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49203","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78835","name":"Rp quan meas single area","description":"Radiopharmaceutical quantification measurement(s) single area (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51600","name":"Injection for bladder x-ray","description":"Injection procedure for cystography or voiding urethrocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85260","name":"Clot factor x stuart-power","description":"Clotting; factor x (stuart-prower)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87450","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31276","name":"Nsl/sins ndsc frnt tiss rmvl","description":"Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20916.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64416","name":"Njx aa&/strd brch pl nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87652","name":"Strep a dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43334","name":"Transthor diaphrag hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; without implantation of mesh or other prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21183","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 40 sq cm but less than 80 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1950.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4102.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92132","name":"Cptrzd oph dx img ant sgm","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), anterior segment, with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1892.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0076T","name":"S&i stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3825.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85097","name":"Bone marrow interpretation","description":"Bone marrow, smear interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1876","name":"Stent, non-coa/non-cov w/del","description":"Stent, non-coated/non-covered, with delivery system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1732.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33415","name":"Revision subvalvular tissue","description":"Resection or incision of subvalvular tissue for discrete subvalvular aortic stenosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1758.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93893","name":"Tcd std icr art ven-art shnt","description":"Transcranial doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99174","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with remote analysis and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33958","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27134","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; both components, with or without autograft or allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1625.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32553","name":"Ins mark thor for rt perq","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-thoracic, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":259.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82820","name":"Hemoglobin-oxygen affinity","description":"Hemoglobin-oxygen affinity (po2 for 50% hemoglobin saturation with oxygen)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93281","name":"Pm device progr eval multi","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10022","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3044.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33140","name":"Heart revascularize (tmr)","description":"Transmyocardial laser revascularization, by thoracotomy; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities: person-centered assessment, performed to better understand the indivi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32484","name":"Segmentectomy","description":"Removal of lung, other than pneumonectomy; single segment (segmentectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81172","name":"Aff2 gen alys charac alleles","description":"Aff2 (alf transcription elongation factor 2 [fmr2]) (eg, fragile x intellectual disability 2 [fraxe]) gene analysis; characterization of alleles (eg, expanded size and methylation status)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1332.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25575","name":"Optx rdl&uln shft fx rds&uln","description":"Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius and ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99457","name":"Rpm tx mgmt 1st 20 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 20 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1732.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54860","name":"Removal of epididymis","description":"Epididymectomy; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62273","name":"Inject epidural patch","description":"Injection, epidural, of blood or clot patch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9955","name":"Inj perflexane lip micros,ml","description":"Injection, perflexane lipid microspheres, per ml","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19350","name":"Nipple/areola reconstruction","description":"Nipple/areola reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92617","name":"Fees w/laryngeal sense i&r","description":"Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23107","name":"Arthrt glenhumrl jt w/expl","description":"Arthrotomy, glenohumeral joint, with joint exploration, with or without removal of loose or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92202","name":"Opscpy extnd on/mac draw","description":"Ophthalmoscopy, extended; with drawing of optic nerve or macula (eg, for glaucoma, macular pathology, tumor) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1725","name":"Cath, translumin non-laser","description":"Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41823","name":"Excision of gum lesion","description":"Excision of osseous tuberosities, dentoalveolar structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"S3818","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53020","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); except infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82646","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0190","name":"Positioning cushion","description":"Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27120","name":"Reconstruction of hip socket","description":"Acetabuloplasty; (eg, whitman, colonna, haygroves, or cup type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82488","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35632","name":"Bpg ilio-celiac","description":"Bypass graft, with other than vein; ilio-celiac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1598.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29871","name":"Arthrs knee surg for infctj","description":"Arthroscopy, knee, surgical; for infection, lavage and drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31545","name":"Remove vc lesion w/scope","description":"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local tissue flap(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75791","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84087","name":"Assay phosphohexose enzymes","description":"Phosphohexose isomerase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44378","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01180","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53601","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22634","name":"Arthrd cmbn 1ntrspc ea addl","description":"Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (list separately in addition to code for prima","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31230","name":"Removal of upper jaw","description":"Maxillectomy; with orbital exenteration (en bloc)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1518.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57280","name":"Suspension of vagina","description":"Colpopexy, abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1391.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34808","name":"Endovas iliac a device addon","description":"Endovascular placement of iliac artery occlusion device (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87285","name":"Treponema pallidum ag if","description":"Infectious agent antigen detection by immunofluorescent technique; treponema pallidum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0311","name":"Immunize counsel 16-30 mins","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 16-30 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4155","name":"Ef incomplete/modular","description":"Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 un","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":691.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57295","name":"Revise vag graft via vagina","description":"Revision (including removal) of prosthetic vaginal graft; vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"Comprehensive hearing test","description":"Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84270","name":"Assay of sex hormone globul","description":"Sex hormone binding globulin (shbg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23077","name":"Rad rescj tum shoulder<5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43275","name":"Ercp remove forgn body duct","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0504","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96131","name":"Psycl tst eval phys/qhp ea","description":"Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78801","name":"Rp loclzj tum 2+area 1+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or m","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92585","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61120","name":"Burr hole for ventr puncture","description":"Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77785","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73719","name":"Mri lower extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80160","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2285.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21060","name":"Remove jaw joint cartilage","description":"Meniscectomy, partial or complete, temporomandibular joint (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2006","name":"Post-d/c h vst ext pt 20 m","description":"Brief (20 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facili","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81286","name":"Fxn gene full gene sequence","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; full gene sequence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26531","name":"Revise knuckle with implant","description":"Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33966","name":"Ecmo/ecls rmvl prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11441","name":"Exc face-mm b9+marg 0.6-1 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49021","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99188","name":"App topical fluoride varnish","description":"Application of topical fluoride varnish by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61501","name":"Craniectomy f/osteomyelitis","description":"Craniectomy; for osteomyelitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57120","name":"Colpocleisis le fort type","description":"Colpocleisis (le fort type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58562","name":"Hysteroscopy remove fb","description":"Hysteroscopy, surgical; with removal of impacted foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53500","name":"Urethrlys transvag w/ scope","description":"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11755.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6218","name":"Non-sterile gauze > 48 sq in","description":"Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29710","name":"Rmvl/bivlv sho/hip spica","description":"Removal or bivalving; shoulder or hip spica, minerva, or risser jacket, etc.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01610","name":"Anes all px nrv musc sho&ax","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33503","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89049","name":"Chct for mal hyperthermia","description":"Caffeine halothane contracture test (chct) for malignant hyperthermia susceptibility, including interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47362","name":"Repair liver wound","description":"Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1215.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1340.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21011","name":"Exc face les sc <2 cm","description":"Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23076","name":"Exc shoulder tum deep < 5 cm","description":"Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1788","name":"Port, indwelling, imp","description":"Port, indwelling (implantable)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86255","name":"Fluorescent antibody screen","description":"Fluorescent noninfectious agent antibody; screen, each antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50370","name":"Rmvl transplanted rnl algrft","description":"Removal of transplanted renal allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1044.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24126","name":"Exc/crtg b1 cst/tum rds algr","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15176","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82787","name":"Igg 1 2 3 or 4 each","description":"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, igg1, 2, 3, or 4), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1756.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43360","name":"Gastrointestinal repair","description":"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with stomach, with or without pyloroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14302","name":"Tis trnfr addl 30 sq cm","description":"Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93456","name":"R hrt coronary artery angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64573","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59070","name":"Transabdom amnioinfus w/us","description":"Transabdominal amnioinfusion, including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86709","name":"Hepatitis a igm antibody","description":"Hepatitis a antibody (haab), igm antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0344","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43196","name":"Esophagoscp guide wire dilat","description":"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3526.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50605","name":"Insert ureteral support","description":"Ureterotomy for insertion of indwelling stent, all types","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20979","name":"Lw ntsty us stimj bone healg","description":"Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4244","name":"Alcohol or peroxide per pint","description":"Alcohol or peroxide, per pint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35142","name":"Repair artery rupture thigh","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, common femoral artery (profunda femoris, superficial femoral)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97032","name":"Appl modality 1+estim ea 15","description":"Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90868","name":"Tcranial magn stim tx deli","description":"Therapeutic repetitive transcranial magnetic stimulation (tms) treatment; subsequent delivery and management, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0144","name":"Azithromycin dihydrate, oral","description":"Azithromycin dihydrate, oral, capsules/powder, 1 gram","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30906","name":"Repeat control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6233.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12017","name":"Rpr fe/e/en/l/m 20.1-30.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4157","name":"Ef special metabolic inherit","description":"Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85337","name":"Thrombomodulin","description":"Thrombomodulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3043.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88305","name":"Tissue exam by pathologist","description":"Level iv - surgical pathology, gross and microscopic examination abortion - spontaneous/missed artery, biopsy bone marrow, biopsy bone exostosis brain/meninges, other than for tumor resection breast, biopsy, not requiring microscopic evaluation of surgical margins breast, reduction mammoplasty bronc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77401","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55550","name":"Laparo ligate spermatic vein","description":"Laparoscopy, surgical, with ligation of spermatic veins for varicocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82633","name":"Desoxycorticosterone","description":"Desoxycorticosterone, 11-","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33512","name":"Cabg vein three","description":"Coronary artery bypass, vein only; 3 coronary venous grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2102.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63267","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23670","name":"Optx sho dislc fx","description":"Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27001","name":"Tenotomy adductor hip open","description":"Tenotomy, adductor of hip, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20100","name":"Expl pentrg wound neck","description":"Exploration of penetrating wound (separate procedure); neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19112","name":"Excise breast duct fistula","description":"Excision of lactiferous duct fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17280","name":"Dstr mal ls f/e/e/n/l/m .5/<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4750","name":"Art or venous blood tubing","description":"Blood tubing, arterial or venous, for hemodialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82677","name":"Assay of estriol","description":"Estriol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33285","name":"Insj subq car rhythm mntr","description":"Insertion, subcutaneous cardiac rhythm monitor, including programming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82017","name":"Acylcarnitines quant","description":"Acylcarnitines; quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","name":"Anes thrcm px trach&bronchi","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea and bronchi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10010","name":"Fna bx w/ct gdn ea addl","description":"Fine needle aspiration biopsy, including ct guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95934","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75671","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99288","name":"Direct advanced life support","description":"Physician or other qualified health care professional direction of emergency medical systems (ems) emergency care, advanced life support","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43211","name":"Esophagoscop mucosal resect","description":"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33465","name":"Replace tricuspid valve","description":"Replacement, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2395.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","name":"Anes px art lower leg nos","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81164","name":"Brca1&2 gen ful dup/del alys","description":"Brca1 (brca1, dna repair associated), brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53235","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); male","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35636","name":"Bpg splenorenal","description":"Bypass graft, with other than vein; splenorenal (splenic to renal arterial anastomosis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1409.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52315","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1887.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25240","name":"Partial removal of ulna","description":"Excision distal ulna partial or complete (eg, darrach type or matched resection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1220.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93231","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35515","name":"Art byp grft subclav-vertbrl","description":"Bypass graft, with vein; subclavian-vertebral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61536","name":"Removal of brain lesion","description":"Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24006","name":"Arthrt elbw capsl exc rls","description":"Arthrotomy of the elbow, with capsular excision for capsular release (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45805","name":"Repair fistula w/colostomy","description":"Closure of rectovesical fistula; with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","name":"Anes px vn knee&pop av fstl","description":"Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96153","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87906","name":"Nfct agt gntyp alys hiv1","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hiv-1, other region (eg, integrase, fusion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0439","name":"Ppps, subseq visit","description":"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35820","name":"Explore chest vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; chest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4458","name":"Reusable enema bag","description":"Enema bag with tubing, reusable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42182","name":"Repair palate","description":"Repair, laceration of palate; over 2 cm or complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402T","name":"Colgn crs-link crn&pachymtry","description":"Collagen cross-linking of cornea, including removal of the corneal epithelium, when performed, and intraoperative pachymetry, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27097","name":"Revision of hip tendon","description":"Release or recession, hamstring, proximal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2559.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20606","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23222","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1268.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4528","name":"Adult size pull-on xl","description":"Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99304","name":"1st nf care sf/low mdm 25","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selection, 25 minutes mus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71271","name":"Ct thorax lung cancer scr c-","description":"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99439","name":"Chrnc care mgmt staf ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15278","name":"Skn sub grft f/n/hf/g ch add","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33976","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1385.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68530","name":"Clearance of tear duct","description":"Removal of foreign body or dacryolith, lacrimal passages","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":6978.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12042","name":"Intmd rpr n-hf/genit2.6-7.5","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94640","name":"Airway inhalation treatment","description":"Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (ippb) device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27690","name":"Revise lower leg tendon","description":"Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial (eg, anterior tibial extensors into midfoot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47560","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27330","name":"Biopsy knee joint lining","description":"Arthrotomy, knee; with synovial biopsy only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96111","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58150","name":"Total hysterectomy","description":"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20926","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6015","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99421","name":"Ol dig e/m svc 5-10 min","description":"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31579","name":"Laryngoscopy telescopic","description":"Laryngoscopy, flexible or rigid telescopic, with stroboscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99254","name":"Ip/obs cnsltj new/est mod 60","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21070","name":"Remove coronoid process","description":"Coronoidectomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26550","name":"Pollicization digit","description":"Pollicization of a digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51597","name":"Removal of pelvic structures","description":"Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1863.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53460","name":"Revision of urethra","description":"Urethromeatoplasty, with partial excision of distal urethral segment (richardson type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49204","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11771","name":"Exc pilonidal cyst xtnsv","description":"Excision of pilonidal cyst or sinus; extensive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","name":"Anes xtrprt lwr abd prst8ect","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67221","name":"Ocular photodynamic ther","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34704","name":"Evasc rpr a-unilac ndgft rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2008.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50100","name":"Trnsxj/repos abrrnt rnl vsls","description":"Transection or repositioning of aberrant renal vessels (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11971","name":"Rmvl tis xpndr wo insj implt","description":"Removal of tissue expander without insertion of implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87624","name":"Hpv hi-risk typ pooled rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62230","name":"Replace/revise brain shunt","description":"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53444","name":"Insert tandem cuff","description":"Insertion of tandem cuff (dual cuff)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36860","name":"External cannula declotting","description":"External cannula declotting (separate procedure); without balloon catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8999","name":"Resuscitation bag","description":"Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42281","name":"Insertion palate prosthesis","description":"Insertion of pin-retained palatal prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63197","name":"Lam w/cordotomy 1stg thrc","description":"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1562.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83872","name":"Assay synovial fluid mucin","description":"Mucin, synovial fluid (ropes test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4668.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85246","name":"Clot factor viii vw antigen","description":"Clotting; factor viii, vw factor antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63704","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; less than 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33621","name":"Transthor cath for stent","description":"Transthoracic insertion of catheter for stent placement with catheter removal and closure (eg, hybrid approach stage 1)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63017","name":"Remove spine lamina >2 lmbr","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25130","name":"Removal of wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26536","name":"Revise/implant finger joint","description":"Arthroplasty, interphalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97803","name":"Med nutrition indiv subseq","description":"Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30468","name":"Rpr nsl vlv collapse w/implt","description":"Repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0372","name":"Md service required for pmd","description":"Physician service required to establish and document the need for a power mobility device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11047","name":"Dbrdmt bone each addl","description":"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88367","name":"Insitu hybridization auto","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33864","name":"Ascending aortic graft","description":"Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with coronary reconstruction and valve-sparing aortic root remodeling (eg, david procedure, yacoub procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2809.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2273.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21083","name":"Impres&prep paltl lft prosth","description":"Impression and custom preparation; palatal lift prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","name":"Anes upr gi ndsc px ercp","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ercp)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49020","name":"Drainage abdom abscess open","description":"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1319.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0005U","name":"Onco prst8 3 gene ur alg","description":"Oncology (prostate) gene expression profile by real-time rt-pcr of 3 genes (erg, pca3, and spdef), urine, algorithm reported as risk score","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33427","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2121.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46070","name":"Incision anal septum infant","description":"Incision, anal septum (infant)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93289","name":"Interrog device eval heart","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including anal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58100","name":"Biopsy of uterus lining","description":"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30150","name":"Rhinectomy partial","description":"Rhinectomy; partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"Init pm e/m new pat 65+ yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and old","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85305","name":"Clot inhibit prot s total","description":"Clotting inhibitors or anticoagulants; protein s, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69710","name":"Implant/replace hearing aid","description":"Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33208","name":"Insrt heart pm atrial & vent","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93533","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1742.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19324","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76816","name":"Ob us follow-up per fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetu","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4570","name":"Splint","description":"Splint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15941","name":"Exc isch pr ulc prm sut ostc","description":"Excision, ischial pressure ulcer, with primary suture; with ostectomy (ischiectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78432","name":"Myocrd img pet 2rtracer","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2244.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14041","name":"Tis trnfr f/c/c/m/n/a/g/h/f","description":"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63301","name":"Remove vert xdrl body thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29405","name":"Appl short leg cast","description":"Application of short leg cast (below knee to toes);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28300","name":"Incision of heel bone","description":"Osteotomy; calcaneus (eg, dwyer or chambers type procedure), with or without internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15782","name":"Dermabrasion other than face","description":"Dermabrasion; regional, other than face","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73702","name":"Ct lwr extremity w/o&w/dye","description":"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9603","name":"One-way allow prorated miles","description":"Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20520","name":"Rmvl fb musc/tdn simple","description":"Removal of foreign body in muscle or tendon sheath; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57455","name":"Biopsy of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33535","name":"Cabg arterial three","description":"Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2132.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15852","name":"Dressing change not for burn","description":"Dressing change (for other than burns) under anesthesia (other than local)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11012","name":"Deb skin bone at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92284","name":"Dx dark adaptation exam i&r","description":"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86408","name":"Neutrlzg antb sarscov2 scr","description":"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]); screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4750","name":"Art or venous blood tubing","description":"Blood tubing, arterial or venous, for hemodialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33533","name":"Cabg arterial single","description":"Coronary artery bypass, using arterial graft(s); single arterial graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37620","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43192","name":"Esophagoscp rig trnso inject","description":"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4527.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65235","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from anterior chamber of eye or lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86200","name":"Ccp antibody","description":"Cyclic citrullinated peptide (ccp), antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88302","name":"Tissue exam by pathologist","description":"Level ii - surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incident","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43405","name":"Ligate/staple esophagus","description":"Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0364","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25077","name":"Resect forearm/wrist tum<3cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3112.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92576","name":"Synthetic sentence id test","description":"Synthetic sentence identification test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5610.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36483","name":"Endoven ther chem adhes sbsq","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442T","name":"Abltj perc plex/trncl nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65850","name":"Trabeculotomy ab externo","description":"Trabeculotomy ab externo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1680.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54163","name":"Repair of circumcision","description":"Repair incomplete circumcision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62355","name":"Remove spinal canal catheter","description":"Removal of previously implanted intrathecal or epidural catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92651","name":"Aep hearing status deter i&r","description":"Auditory evoked potentials; for hearing status determination, broadband stimuli, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11604","name":"Exc tr-ext mal+marg 3.1-4 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41100","name":"Biopsy of tongue","description":"Biopsy of tongue; anterior two-thirds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68540","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; frontal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42831","name":"Removal of adenoids","description":"Adenoidectomy, primary; age 12 or over","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62326","name":"Njx interlaminar lmbr/sac","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21047","name":"Excise lwr jaw cyst w/repair","description":"Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92596","name":"Ear protector evaluation","description":"Ear protector attenuation measurements","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26030","name":"Drainage of palm bursas","description":"Drainage of palmar bursa; multiple bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32540","name":"Removal of lung lesion","description":"Extrapleural enucleation of empyema (empyemectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1385.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51795","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90811","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21490","name":"Optx tmprmand dislocation","description":"Open treatment of temporomandibular dislocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50545","name":"Laparo radical nephrectomy","description":"Laparoscopy, surgical; radical nephrectomy (includes removal of gerotas fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27696","name":"Repair of ankle ligaments","description":"Repair, primary, disrupted ligament, ankle; both collateral ligaments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64425","name":"Njx aa&/strd ii ih nerves","description":"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47620","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1155.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26548","name":"Reconstruct finger joint","description":"Repair and reconstruction, finger, volar plate, interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25440","name":"Repair nonu scphd carpl b1","description":"Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial styloidectomy (includes obtaining graft and necessary fixation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35182","name":"Rpr cgen av fistula thrx&abd","description":"Repair, congenital arteriovenous fistula; thorax and abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1554.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1872.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15771","name":"Grfg autol fat lipo 50 cc/<","description":"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91012","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2212","name":"Prolong outpt/office vis","description":"Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or w","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3212","name":"Benesch boot pair infant","description":"Benesch boot, pair, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43192","name":"Esophagoscp rig trnso inject","description":"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21932","name":"Exc back tum deep < 5 cm","description":"Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95962","name":"Electrode stim brain add-on","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93464","name":"Exercise w/hemodynamic meas","description":"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42145","name":"Repair palate pharynx/uvula","description":"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27720","name":"Repair of tibia","description":"Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26952","name":"Amputation of finger/thumb","description":"Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with local advancement flaps (v-y, hood)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74712","name":"Mri fetal sngl/1st gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0367","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44203","name":"Lap resect s/intestine addl","description":"Laparoscopy, surgical; each additional small intestine resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":601.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61705","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2395.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49402","name":"Remove foreign body adbomen","description":"Removal of peritoneal foreign body from peritoneal cavity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92537","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2453.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19300","name":"Mastectomy for gynecomastia","description":"Mastectomy for gynecomastia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81422","name":"Fetal chrmoml microdeltj","description":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, digeorge syndrome, cri-du-chat syndrome), circulating cell-free fetal dna in maternal blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75893","name":"Venous sampling by catheter","description":"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19105","name":"Cryosurg ablate fa each","description":"Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each fibroadenoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34701","name":"Evasc rpr a-ao ndgft","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36471","name":"Njx sclrsnt mlt incmptnt vn","description":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87538","name":"Hiv-2 probe&revrse trnscripj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-2, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31287","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27510","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40500","name":"Partial excision of lip","description":"Vermilionectomy (lip shave), with mucosal advancement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2525.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71035","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99477","name":"Init day hosp neonate care","description":"Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or younger, who requires intensive observation, frequent interventions, and other intensive care services","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35355","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliofemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64520","name":"N block lumbar/thoracic","description":"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1756.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71021","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0517","name":"Remove drug implant","description":"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42120","name":"Remove palate/lesion","description":"Resection of palate or extensive resection of lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64520","name":"N block lumbar/thoracic","description":"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33508","name":"Endoscopic vein harvest","description":"Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36227","name":"Place cath xtrnl carotid","description":"Selective catheter placement, external carotid artery, unilateral, with angiography of the ipsilateral external carotid circulation and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63173","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6261","name":"Wound filler gel/paste /oz","description":"Wound filler, gel/paste, per fluid ounce, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35645","name":"Bpg subclavian-vertebral","description":"Bypass graft, with other than vein; subclavian-vertebral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54861","name":"Removal of epididymis","description":"Epididymectomy; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64570","name":"Remove vagus n eltrd","description":"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93892","name":"Tcd emboli detect w/o inj","description":"Transcranial doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81310","name":"Npm1 gene","description":"Npm1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72130","name":"Ct chest spine w/o & w/dye","description":"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89325","name":"Sperm antibody test","description":"Sperm antibodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0165T","name":"Revise lumb artif disc addl","description":"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33361","name":"Replace aortic valve perq","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; percutaneous femoral artery approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51798","name":"Us urine capacity measure","description":"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0898","name":"Power wheelchair noc","description":"Power wheelchair, not otherwise classified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1124.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61538","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2457.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41112","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; anterior two-thirds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1606.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64590","name":"Ins/rpl prph sac/gstr npg/r","description":"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4230","name":"Infus insulin pump non needl","description":"Infusion set for external insulin pump, non needle cannula type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2034.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69806","name":"Explore inner ear","description":"Endolymphatic sac operation; with shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33641","name":"Repair heart septum defect","description":"Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or without patch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1425.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"Prev visit est age 5-11","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25430","name":"Vasc graft into carpal bone","description":"Insertion of vascular pedicle into carpal bone (eg, hori procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97814","name":"Acup 1/> w/estim ea addl 15","description":"Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35686","name":"Bypass graft/av fist patency","description":"Creation of distal arteriovenous fistula during lower extremity bypass surgery (non-hemodialysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0168","name":"Wound closure by adhesive","description":"Wound closure utilizing tissue adhesive(s) only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23335","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (eg, total shoulder)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58953","name":"Tah rad dissect for debulk","description":"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1275.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73202","name":"Ct uppr extremity w/o&w/dye","description":"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84244","name":"Assay of renin","description":"Renin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52265","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31300","name":"Removal of larynx lesion","description":"Laryngotomy (thyrotomy, laryngofissure), with removal of tumor or laryngocele, cordectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":948.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29827","name":"Sho arthrs srg rt8tr cuf rpr","description":"Arthroscopy, shoulder, surgical; with rotator cuff repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93320","name":"Doppler echo complete","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9678","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21175","name":"Rcnst bfrnt sp orb rm&lw fhd","description":"Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61642","name":"Dilat ic vspsm ea diff ter","description":"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96004","name":"Phys review of motion tests","description":"Review and interpretation by physician or other qualified health care professional of comprehensive computer-based motion analysis, dynamic plantar pressure measurements, dynamic surface electromyography during walking or other functional activities, and dynamic fine wire electromyography, with writ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33286","name":"Rmvl subq car rhythm mntr","description":"Removal, subcutaneous cardiac rhythm monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46611","name":"Anoscopy","description":"Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43860","name":"Revj gstr/jj anast w/o vgtmy","description":"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; without vagotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1364.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93790","name":"Ambl bp mntr w/sw i&r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; review with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4641","name":"Radiopharm dx agent noc","description":"Radiopharmaceutical, diagnostic, not otherwise classified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0353T","name":"Intraop oct breast cavity","description":"Optical coherence tomography of breast, surgical cavity; real-time intraoperative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11600","name":"Exc tr-ext mal+marg 0.5 cm/<","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23410","name":"Repair rotator cuff acute","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1872.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25605","name":"Cltx dst rdl fx/ephys sep w/","description":"Closed treatment of distal radial fracture (eg, colles or smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51710","name":"Change of bladder tube","description":"Change of cystostomy tube; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96171","name":"Hlth bhv ivntj fam w/o pt ea","description":"Health behavior intervention, family (without the patient present), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64484","name":"Njx aa&/strd tfrm epi l/s ea","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), lumbar or sacral, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1590.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99462","name":"Sbsq nb em per day hosp","description":"Subsequent hospital care, per day, for evaluation and management of normal newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82975","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","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, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","name":"Anes open total ankle rplcmt","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91037","name":"Esoph imped function test","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13133","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","description":"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20701","name":"Rmvl deep rx delivery device","description":"Removal of drug-delivery device(s), deep (eg, subfascial) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57270","name":"Repair of bowel pouch","description":"Repair of enterocele, abdominal approach (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25608","name":"Optx dst rd xart fx/epi sep2","description":"Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 2 fragments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83788","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35525","name":"Art byp grft brachial-brchl","description":"Bypass graft, with vein; brachial-brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64614","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88141","name":"Cytopath c/v interpret","description":"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87281","name":"Pneumocystis carinii ag if","description":"Infectious agent antigen detection by immunofluorescent technique; pneumocystis carinii","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67400","name":"Explore/biopsy eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23130","name":"Acromp/acromionectomy prtl","description":"Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4212","name":"Non coring needle or stylet","description":"Non-coring needle or stylet with or without catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35516","name":"Art byp grft subclav-axilary","description":"Bypass graft, with vein; subclavian-axillary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59830","name":"Treat uterus infection","description":"Treatment of septic abortion, completed surgically","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10035","name":"Plmt sft tiss loclzj dev 1st","description":"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54417","name":"Remv/replc penis pros compl","description":"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84442","name":"Assay of thyroid activity","description":"Thyroxine binding globulin (tbg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84479","name":"Assay of thyroid (t3 or t4)","description":"Thyroid hormone (t3 or t4) uptake or thyroid hormone binding ratio (thbr)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42806","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, survey for unknown primary lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69150","name":"Extensive ear canal surgery","description":"Radical excision external auditory canal lesion; without neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20955","name":"Fibula bone graft microvasc","description":"Bone graft with microvascular anastomosis; fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2031.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87277","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22848","name":"Insert pelv fixation device","description":"Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54690","name":"Laparoscopy orchiectomy","description":"Laparoscopy, surgical; orchiectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87158","name":"Culture typing added method","description":"Culture, typing; other methods","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0316","name":"Prolong inpt eval add15 m","description":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99236","name":"Hosp ip/obs same date hi 85","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter f","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12034","name":"Intmd rpr s/tr/ext 7.6-12.5","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32606","name":"Thoracoscopy w/bx med space","description":"Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":84.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96366","name":"Ther/proph/diag iv inf addon","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74340","name":"X-ray guide for gi tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott), including multiple fluoroscopies and images, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54640","name":"Orchiopexy ingun/scrot appr","description":"Orchiopexy, inguinal or scrotal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65760","name":"Keratomileusis","description":"Keratomileusis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70496","name":"Ct angiography head","description":"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33688","name":"Clsr 1vsd w/wo ptch rmvl bnd","description":"Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27740","name":"Repair of leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44203","name":"Lap resect s/intestine addl","description":"Laparoscopy, surgical; each additional small intestine resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30630","name":"Repair nasal septum defect","description":"Repair nasal septal perforations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33221","name":"Insert pulse gen mult leads","description":"Insertion of pacemaker pulse generator only; with existing multiple leads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78808","name":"Iv inj ra drug dx study","description":"Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid adenoma)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50200","name":"Renal biopsy perq","description":"Renal biopsy; percutaneous, by trocar or needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26916.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95044","name":"Patch/application tests","description":"Patch or application test(s) (specify number of tests)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43217","name":"Esophagoscopy snare les remv","description":"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"Home/res vst est mod mdm 40","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or excee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6473.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24582","name":"Prq skel fix humrl cndylr fx","description":"Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20802","name":"Replantation arm complete","description":"Replantation, arm (includes surgical neck of humerus through elbow joint), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2335.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65272","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47400","name":"Incision of liver duct","description":"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1810.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29891","name":"Arthr ank ostchn df tal&/tib","description":"Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62147","name":"Crnop w/autograft>5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1276.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15156","name":"Tis clt agrft f/s/n/h/f/g ad","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; additional 1 sq cm to 75 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47371","name":"Laparo ablate liver cryosurg","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4793.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KF"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27194","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99151","name":"Mod sed same phys/qhp <5 yrs","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3249.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43337","name":"Thorabd diaphr hern repair","description":"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; with implantation of mesh or other prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1284.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33284","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96574","name":"Dbrdmt prmlg les w/pdt","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35671","name":"Bpg pop-tibl/-prnl artery","description":"Bypass graft, with other than vein; popliteal-tibial or -peroneal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84560","name":"Assay of urine/uric acid","description":"Uric acid; other source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61782","name":"Scan proc cranial extra","description":"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27612","name":"Exploration of ankle joint","description":"Arthrotomy, posterior capsular release, ankle, with or without achilles tendon lengthening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":790.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]},{"negotiated_type":"negotiated","negotiated_rate":0.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63655","name":"Implant neuroelectrodes","description":"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1321.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12036","name":"Intmd rpr s/a/t/ext 20.1-30","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82646","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93923","name":"Upr/lxtr art stdy 3+ lvls","description":"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional doppler wave","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87621","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3455.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28615","name":"Repair foot dislocation","description":"Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82652","name":"Vit d 1 25-dihydroxy","description":"Vitamin d; 1, 25 dihydroxy, includes fraction(s), if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33130","name":"Rescj external cardiac tumor","description":"Resection of external cardiac tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1184.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36261","name":"Revision of infusion pump","description":"Revision of implanted intra-arterial infusion pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55874","name":"Tprnl plmt biodegrdabl matrl","description":"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26517","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 2 digits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89130","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56515","name":"Destroy vulva lesion/s compl","description":"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4994.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6026.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"Psytx w pt w e/m 45 min","description":"Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9016","name":"Rbc leukocytes reduced","description":"Red blood cells, leukocytes reduced, each unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51727","name":"Cystometrogram w/up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","KL","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42831","name":"Removal of adenoids","description":"Adenoidectomy, primary; age 12 or over","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2082","name":"Visit esketamine 56m or less","description":"Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self-administration, includes 2 hours post-administration observation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","21","49","02","65","81","32","11","24","22","33","10","13","12","31"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77412","name":"Radiation tx delivery lvl 3","description":"Radiation treatment delivery; level 3, multiple isocenters with photon therapy (eg, 2d, 3d, or imrt) or a single-isocenter photon therapy (eg, 3d or imrt) with active motion management, or total skin electrons, or mixed-electron/photon field(s), including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31553","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, with indwelling stent placement, younger than 12 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27307","name":"Incision of thigh tendons","description":"Tenotomy, percutaneous, adductor or hamstring; multiple tendons","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87515","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99251","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73503","name":"X-ray exam hip uni 4/> views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21050","name":"Removal of jaw joint","description":"Condylectomy, temporomandibular joint (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":701.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21555","name":"Exc neck les sc < 3 cm","description":"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69433","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27465","name":"Shortening of thigh bone","description":"Osteoplasty, femur; shortening (excluding 64876)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3047.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0422","name":"Intens cardiac rehab w/exerc","description":"Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3799.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27767","name":"Cltx post ankle fx","description":"Closed treatment of posterior malleolus fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6262","name":"Wound filler dry form / gram","description":"Wound filler, dry form, per gram, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25446","name":"Arthrp w/prostc dst rds&crps","description":"Arthroplasty with prosthetic replacement; distal radius and partial or entire carpus (total wrist)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89100","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86078","name":"Phys blood bank serv reactj","description":"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22634","name":"Arthrd cmbn 1ntrspc ea addl","description":"Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (list separately in addition to code for prima","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87340","name":"Hepatitis b surface ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67930","name":"Repair eyelid wound","description":"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2096.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96110","name":"Developmental screen w/score","description":"Developmental screening (eg, developmental milestone survey, speech and language delay screen), with scoring and documentation, per standardized instrument","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25370","name":"Revise radius or ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius or ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3475.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58700","name":"Removal of fallopian tube","description":"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11975","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35236","name":"Repair blvsl vn grf uxtr","description":"Repair blood vessel with vein graft; upper extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74174","name":"Cta abd&plvs w/contrast","description":"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76828","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36861","name":"Cannula declotting","description":"External cannula declotting (separate procedure); with balloon catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","name":"Anes px art lower leg nos","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97755","name":"Assistive technology assess","description":"Assistive technology assessment (eg, to restore, augment or compensate for existing function, optimize functional tasks and/or maximize environmental accessibility), direct one-on-one contact, with written report, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"Office o/p est hi 40 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27331","name":"Explore/treat knee joint","description":"Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67710","name":"Severing tarsorrhaphy","description":"Severing of tarsorrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1828.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12053","name":"Intmd rpr face/mm 5.1-7.5 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83907","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50365","name":"Rnl altrnsplj w/rcp nfrct","description":"Renal allotransplantation, implantation of graft; with recipient nephrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2498.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33250","name":"Ablate heart dysrhythm focus","description":"Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, wolff-parkinson-white, atrioventricular node re-entry), tract(s) and/or focus (foci); without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97164","name":"Pt re-eval est plan care","description":"Re-evaluation of physical therapy established plan of care, requiring these components: an examination including a review of history and use of standardized tests and measures is required; and revised plan of care using a standardized patient assessment instrument and/or measurable assessment of fun","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21310","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92060","name":"Sensorimotor examination","description":"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83550","name":"Iron binding test","description":"Iron binding capacity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63076","name":"Neck spine disk surgery","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42215","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; major revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34802","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1056.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61543","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78814","name":"Pet image w/ct lmtd","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22841","name":"Insert spine fixation device","description":"Internal spinal fixation by wiring of spinous processes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26562","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; complex (eg, involving bone, nails)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95714","name":"Veeg ea 12-26 hr unmntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, each increment of 12-26 hours; unmonitored","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43351","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; thoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57112","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1167.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70481","name":"Ct orbit/ear/fossa w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82009","name":"Ketone bodys qual","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96375","name":"Tx/pro/dx inj new drug addon","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1758","name":"Catheter, ureteral","description":"Catheter, ureteral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31295","name":"Nsl/sins ndsc surg max sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); maxillary sinus ostium, transnasal or via canine fossa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1407.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85536","name":"Iron stain peripheral blood","description":"Iron stain, peripheral blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65112","name":"Remove eye/revise socket","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"Medical nutrition group","description":"Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97610","name":"Low frequency non-thermal us","description":"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29450","name":"Application clubfoot cast","description":"Application of clubfoot cast with molding or manipulation, long or short leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82306","name":"Vitamin d 25 hydroxy","description":"Vitamin d; 25 hydroxy, includes fraction(s), if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93462","name":"L hrt cath trnsptl puncture","description":"Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26542","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local tissue (eg, adductor advancement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27280","name":"Arthr si jt opn b1grf instrm","description":"Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1186.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45308","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0337","name":"Hospice evaluation preelecti","description":"Hospice evaluation and counseling services, pre-election","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82585","name":"Assay of cryofibrinogen","description":"Cryofibrinogen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70558","name":"Mri brain w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33677","name":"Cl mult vsd w/rem pul band","description":"Closure of multiple ventricular septal defects; with removal of pulmonary artery band, with or without gusset","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1830.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45113","name":"Partial proctectomy","description":"Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (s or j), with or without loop ileostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1460.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2013","name":"Post-d/c h vst ext pt 75 m","description":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient fa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1020.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41250","name":"Repair tongue laceration","description":"Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AV","AU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90937","name":"Hemodialysis repeated eval","description":"Hemodialysis procedure requiring repeated evaluation(s) with or without substantial revision of dialysis prescription","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84143","name":"Assay of 17-hydroxypregneno","description":"17-hydroxypregnenolone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86156","name":"Cold agglutinin screen","description":"Cold agglutinin; screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17311","name":"Mohs 1 stage h/n/hf/g","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), h","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92134","name":"Cptrz oph dx img pst sgm rta","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90947","name":"Dialysis repeated eval","description":"Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies) requiring repeated evaluations by a physician or other qualified health care professional, with or without substantial revision of dialysis prescription","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51990","name":"Laparo urethral suspension","description":"Laparoscopy, surgical; urethral suspension for stress incontinence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29887","name":"Arthrs knee srg drlg od fixj","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93280","name":"Pm device progr eval dual","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20972","name":"Bone/skin graft metatarsal","description":"Free osteocutaneous flap with microvascular anastomosis; metatarsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2421.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33430","name":"Replacement of mitral valve","description":"Replacement, mitral valve, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00452","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68705","name":"Revise tear duct opening","description":"Correction of everted punctum, cautery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12007","name":"Rpr s/n/ax/gen/trnk >30.0 cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49600","name":"Repair umbilical lesion","description":"Repair of small omphalocele, with primary closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84165","name":"Protein e-phoresis serum","description":"Protein; electrophoretic fractionation and quantitation, serum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52317","name":"Remove bladder stone","description":"Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92526","name":"Oral function therapy","description":"Treatment of swallowing dysfunction and/or oral function for feeding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"R0070","name":"Transport portable x-ray","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49450","name":"Replace g/c tube perc","description":"Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84030","name":"Assay of blood pku","description":"Phenylalanine (pku), blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15936","name":"Exc sac pr ulc prep mus flap","description":"Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2250","name":"Remot img sub by pt, non e/m","description":"Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or p","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82160","name":"Assay of androsterone","description":"Androsterone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44312","name":"Revision of ileostomy","description":"Revision of ileostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77058","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34711","name":"Dlyd plmt xtn prosth ea addl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4222","name":"Parenteral supply kit homemi","description":"Parenteral nutrition supply kit; home mix, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43753","name":"Tx gastro intub w/asp","description":"Gastric intubation and aspiration(s) therapeutic, necessitating physicians skill (eg, for gastrointestinal hemorrhage), including lavage if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21280","name":"Medial canthopexy","description":"Medial canthopexy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93982","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60521","name":"Removal of thymus gland","description":"Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78432","name":"Myocrd img pet 2rtracer","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2244.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82585","name":"Assay of cryofibrinogen","description":"Cryofibrinogen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48153","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); with pancreatojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2598.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36200","name":"Place catheter in aorta","description":"Introduction of catheter, aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76826","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90869","name":"Tcran magn stim redetemine","description":"Therapeutic repetitive transcranial magnetic stimulation (tms) treatment; subsequent motor threshold re-determination with delivery and management","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35506","name":"Art byp grft subclav-carotid","description":"Bypass graft, with vein; carotid-subclavian or subclavian-carotid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1125.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58350","name":"Reopen fallopian tube","description":"Chromotubation of oviduct, including materials","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83891","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96423","name":"Chemo ia infuse each addl hr","description":"Chemotherapy administration, intra-arterial; infusion technique, each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","name":"Anes male gent undscnd tstis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10008","name":"Fna bx w/fluor gdn ea addl","description":"Fine needle aspiration biopsy, including fluoroscopic guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11471","name":"Exc skn h/p/p/u complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with complex repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1610.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33964","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition central cannula(e) by sternotomy or thoracotomy, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","name":"Anes arthr/ndsc wrst/hnd nos","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27591","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; immediate fitting technique including first cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36100","name":"Establish access to artery","description":"Introduction of needle or intracatheter, carotid or vertebral artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","name":"Neuraxl lbr anes vag dlvr","description":"Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27079","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP18","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94662","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26100","name":"Biopsy hand joint lining","description":"Arthrotomy with biopsy; carpometacarpal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85460","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; differential lysis (kleihauer-betke)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3557.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4520","name":"Incontinence garment anytype","description":"Incontinence garment, any type, (e.g., brief, diaper), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93511","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50900","name":"Repair of ureter","description":"Ureterorrhaphy, suture of ureter (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9489","name":"Remote e/m est. pt 40mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved coms innovation center demonstration project, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision makin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24073","name":"Ex arm/elbow tum deep 5 cm/>","description":"Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78431","name":"Myocrd img pet rst&strs ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1776.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57270","name":"Repair of bowel pouch","description":"Repair of enterocele, abdominal approach (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93281","name":"Pm device progr eval multi","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67505","name":"Inject/treat eye socket","description":"Retrobulbar injection; alcohol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34812","name":"Opn fem art expos","description":"Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86140","name":"C-reactive protein","description":"C-reactive protein;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94762","name":"N-invas ear/pls oximtry cont","description":"Noninvasive ear or pulse oximetry for oxygen saturation; by continuous overnight monitoring (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46751","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78802","name":"Rp loclzj tum whbdy 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1509.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92569","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29583","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2232.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23020","name":"Capsular contracture release","description":"Capsular contracture release (eg, sever type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75902","name":"Remove cva lumen obstruct","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63661","name":"Remove spine eltrd perq aray","description":"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19288","name":"Perq dev breast add mr guide","description":"Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including magnetic resonance guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80069","name":"Renal function panel","description":"Renal function panel this panel must include the following: albumin (82040) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphorus inorganic (phosphate) (84100) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66852","name":"Removal of lens material","description":"Removal of lens material; pars plana approach, with or without vitrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1431.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33777","name":"Rpr tga bfl rpr sbpulm obstr","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with repair of subpulmonic obstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1645.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36902","name":"Intro cath dialysis circuit","description":"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous out","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57292","name":"Construct vagina with graft","description":"Construction of artificial vagina; with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50610","name":"Removal of ureter stone","description":"Ureterolithotomy; upper one-third of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32606","name":"Thoracoscopy w/bx med space","description":"Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96121","name":"Nubhvl xm phy/qhp ea addl hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45563","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury; with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1385.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24076","name":"Ex arm/elbow tum deep < 5 cm","description":"Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51800","name":"Revision of bladder/urethra","description":"Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33362","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open femoral artery approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27685","name":"Revision of lower leg tendon","description":"Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11446","name":"Exc face-mm b9+marg >4 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43800","name":"Pyloroplasty","description":"Pyloroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01230","name":"Anes opn upper 2/3 femur nos","description":"Anesthesia for open procedures involving upper two-thirds of femur; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13100","name":"Cmplx rpr trunk 1.1-2.5 cm","description":"Repair, complex, trunk; 1.1 cm to 2.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38380","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4236.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4185","name":"Pn soln nos 10 grams lipids","description":"Parenteral nutrition solution, not otherwise specified, 10 grams lipids","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88331","name":"Path consltj surg 1 blk 1spc","description":"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74340","name":"X-ray guide for gi tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott), including multiple fluoroscopies and images, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43882","name":"Rev/rmvl gstr nstim eltrd","description":"Revision or removal of gastric neurostimulator electrodes, antrum, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87529","name":"Hsv dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65135","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26500","name":"Hand tendon reconstruction","description":"Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31631","name":"Bronchoscopy dilate w/stent","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of tracheal stent(s) (includes tracheal/bronchial dilation as required)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32998","name":"Ablate pulm tumor perq rf","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2604.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92012","name":"Intrm oph exam est patient","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65780","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578T","name":"Rem interrog dev icds phys","description":"Interrogation device evaluation(s) (remote), up to 90 days, substernal lead implantable cardioverter-defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27884","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99447","name":"Ntrprof ph1/ntrnet/ehr 11-20","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45380","name":"Colonoscopy and biopsy","description":"Colonoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74249","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58356","name":"Endometrial cryoablation","description":"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1142.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","name":"Anes all px nck ndl bx thyr","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43256","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93321","name":"Doppler echo f-up/lmtd std","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13150","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10238.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26471","name":"Fusion of finger tendons","description":"Tenodesis; of proximal interphalangeal joint, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37620","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54550","name":"Exploration for testis","description":"Exploration for undescended testis (inguinal or scrotal area)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63281","name":"Bx/exc idrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1914.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4463.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","name":"Anes thrcm px pulm rescj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4046.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24800","name":"Arthrodesis elbw joint local","description":"Arthrodesis, elbow joint; local","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":701.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32141","name":"Remove/treat lung lesions","description":"Thoracotomy; with resection-plication of bullae, includes any pleural procedure when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27441","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71270","name":"Ct thorax dx c-/c+","description":"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25905","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna; open, circular (guillotine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43272","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00756","name":"Anes hrna rpr diphrg hrna","description":"Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23935","name":"Inc dp opn b1 crtx hum/elbw","description":"Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), humerus or elbow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26531","name":"Revise knuckle with implant","description":"Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92311","name":"Contact lens fitg aphakia 1","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, 1 eye","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44015","name":"Insert needle cath bowel","description":"Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43410","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53431","name":"Reconstruct urethra/bladder","description":"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, tenago, leadbetter procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26498","name":"Finger tendon transfer","description":"Transfer of tendon to restore intrinsic function; all 4 fingers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62273","name":"Inject epidural patch","description":"Injection, epidural, of blood or clot patch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35551","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51525","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54057","name":"Laser surg penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63182","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1488.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":190.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88325","name":"Consltj compre rvw rec reprt","description":"Consultation, comprehensive, with review of records and specimens, with report on referred material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82286","name":"Assay of bradykinin","description":"Bradykinin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64455","name":"Njx aa&/strd pltr com dg nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; plantar common digital nerve(s) (eg, mortons neuroma)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378T","name":"Visual field assmnt rev/rprt","description":"Visual field assessment, with concurrent real time data analysis and accessible data storage with patient initiated data transmitted to a remote surveillance center for up to 30 days; review and interpretation with report by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48155.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0241U","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71275","name":"Ct angiography chest","description":"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6240.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21122","name":"Geniop sldg osteot 2/>","description":"Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22318","name":"Treat odontoid fx w/o graft","description":"Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28820","name":"Amputation of toe","description":"Amputation, toe; metatarsophalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95805","name":"Multiple sleep latency test","description":"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49566","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35266","name":"Rpr blvsl grf oth/th vn uxtr","description":"Repair blood vessel with graft other than vein; upper extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54316","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92590","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29887","name":"Arthrs knee srg drlg od fixj","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26676","name":"Pin hand dislocation","description":"Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, with manipulation, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5441.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11446","name":"Exc face-mm b9+marg >4 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69433","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84144","name":"Assay of progesterone","description":"Progesterone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56633","name":"Vulvectomy radical complete","description":"Vulvectomy, radical, complete;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57410","name":"Pelvic examination","description":"Pelvic examination under anesthesia (other than local)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78473","name":"Gated heart multiple","description":"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64495","name":"Inj paravert f jnt l/s 3 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; third and any additional level(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65785","name":"Impltj ntrstrml crnl rng seg","description":"Implantation of intrastromal corneal ring segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1470.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76886","name":"Us exam infant hips static","description":"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25447","name":"Arthrp ntrcrp/crp/mtcr ntrps","description":"Arthroplasty, intercarpal or carpometacarpal joints; interposition (eg, tendon)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82135","name":"Assay aminolevulinic acid","description":"Aminolevulinic acid, delta (ala)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58544","name":"Lsh w/t/o uterus above 250 g","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62361","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26070","name":"Explore/treat hand joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93564","name":"Njx cgen car cath slctv opac","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aortocoronary saphenous vein, free radial artery, or free mammary artery graft) to one or more coronary a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97162","name":"Pt eval mod complex 30 min","description":"Physical therapy evaluation: moderate complexity, requiring these components: a history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; an examination of body systems using standardized tests and measures in addressing a total of 3 or more elements fro","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58400","name":"Suspension of uterus","description":"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21194","name":"Reconst lwr jaw w/graft","description":"Reconstruction of mandibular rami, horizontal, vertical, c, or l osteotomy; with bone graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1144.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92100","name":"Serial tonometry","description":"Serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day (eg, diurnal curve or medical treatment of acute elevation of intraocular pressure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29915","name":"Hip arthro acetabuloplasty","description":"Arthroscopy, hip, surgical; with acetabuloplasty (ie, treatment of pincer lesion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97164","name":"Pt re-eval est plan care","description":"Re-evaluation of physical therapy established plan of care, requiring these components: an examination including a review of history and use of standardized tests and measures is required; and revised plan of care using a standardized patient assessment instrument and/or measurable assessment of fun","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00634","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52351","name":"Cystouretero & or pyeloscope","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99304","name":"1st nf care sf/low mdm 25","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selection, 25 minutes mus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99183","name":"Hyperbaric oxygen therapy","description":"Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90818","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82384","name":"Assay three catecholamines","description":"Catecholamines; fractionated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6208","name":"Contact layer > 48 sq in","description":"Contact layer, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E8002","name":"Anterior gait trainer","description":"Gait trainer, pediatric size, anterior support, includes all accessories and components","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44050","name":"Reduce bowel obstruction","description":"Reduction of volvulus, intussusception, internal hernia, by laparotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83906","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78429","name":"Myocrd img pet 1 std w/ct","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27808","name":"Treatment of ankle fracture","description":"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","name":"Anes opn/arthrs knee jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49422","name":"Remove tunneled ip cath","description":"Removal of tunneled intraperitoneal catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57423","name":"Repair paravag defect lap","description":"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33413","name":"Replacement of aortic valve","description":"Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (ross procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2813.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25909","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; re-amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62269","name":"Needle biopsy spinal cord","description":"Biopsy of spinal cord, percutaneous needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95801","name":"Slp stdy unatnd w/anal","description":"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44345","name":"Revision of colostomy","description":"Revision of colostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78270","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90869","name":"Tcran magn stim redetemine","description":"Therapeutic repetitive transcranial magnetic stimulation (tms) treatment; subsequent motor threshold re-determination with delivery and management","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92227","name":"Img rta detcj/mntr ds staff","description":"Imaging of retina for detection or monitoring of disease; with remote clinical staff review and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":525.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99245","name":"Off/op consltj new/est hi 55","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44604","name":"Suture large intestine","description":"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37224","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93352","name":"Admin ecg contrast agent","description":"Use of echocardiographic contrast agent during stress echocardiography (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2909.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92630","name":"Aud rehab pre-ling hear loss","description":"Auditory rehabilitation; prelingual hearing loss","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27364","name":"Resect thigh/knee tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99185","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9537","name":"Tc99m mebrofenin","description":"Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3798.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1905.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25120","name":"Removal of forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92970","name":"Cardioassist internal","description":"Cardioassist-method of circulatory assist; internal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35518","name":"Art byp grft axillary-axilry","description":"Bypass graft, with vein; axillary-axillary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1009.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2015","name":"Post-d/c care plan overs 60m","description":"Comprehensive (60 mins) home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44205","name":"Lap colectomy part w/ileum","description":"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56515","name":"Destroy vulva lesion/s compl","description":"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42950","name":"Reconstruction of throat","description":"Pharyngoplasty (plastic or reconstructive operation on pharynx)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521T","name":"Interrog dev eval wcs ip","description":"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24331","name":"Flexor-plasty elbw w/advmnt","description":"Flexor-plasty, elbow (eg, steindler type advancement); with extensor advancement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44700","name":"Suspend bowel w/prosthesis","description":"Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg, bladder or omentum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86833","name":"Hla class ii high defin qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, individual antigen per bead methodology), hla class ii","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45339","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63707","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87280","name":"Respiratory syncytial ag if","description":"Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50323","name":"Prep cadaver renal allograft","description":"Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision of adrenal gland, and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65900","name":"Remove eye lesion","description":"Removal of epithelial downgrowth, anterior chamber of eye","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59050","name":"Fetal monitor w/report","description":"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97004","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439T","name":"Myocrd contrast prfuj echo","description":"Myocardial contrast perfusion echocardiography, at rest or with stress, for assessment of myocardial ischemia or viability (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30520","name":"Repair of nasal septum","description":"Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13131","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","description":"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99407","name":"Behav chng smoking > 10 min","description":"Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47361","name":"Repair liver wound","description":"Management of liver hemorrhage; exploration of hepatic wound, extensive debridement, coagulation and/or suture, with or without packing of liver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2527.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85220","name":"Blooc clot factor v test","description":"Clotting; factor v (acg or proaccelerin), labile factor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55600","name":"Vesiculotomy","description":"Vesiculotomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81413","name":"Car ion chnnlpath inc 10 gns","description":"Cardiac ion channelopathies (eg, brugada syndrome, long qt syndrome, short qt syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing of at least 10 genes, including ank2, casq2, cav3, kcne1, kcne2, kcnh2, kcnj2, kcnq1, ryr2, and scn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23155","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6086.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51535","name":"Repair of ureter lesion","description":"Cystotomy for excision, incision, or repair of ureterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70543","name":"Mri orbt/fac/nck w/o &w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75658","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","name":"Anes px nrv musc upr a&e nos","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52235","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01190","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35188","name":"Rpr acq av fistula head&neck","description":"Repair, acquired or traumatic arteriovenous fistula; head and neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96370","name":"Sc ther infusion addl hr","description":"Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74248","name":"X-ray sm int f-thru std","description":"Radiologic small intestine follow-through study, including multiple serial images (list separately in addition to code for primary procedure for upper gi radiologic examination)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61597","name":"Transcondylar approach/skull","description":"Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of c1-c3 vertebral body(s), decompression of vertebral artery, with or without mobilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2661.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57150","name":"Treat vagina infection","description":"Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93702","name":"Bis xtracell fluid analysis","description":"Bioimpedance spectroscopy (bis), extracellular fluid analysis for lymphedema assessment(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21406","name":"Opn tx orbit fx w/o implant","description":"Open treatment of fracture of orbit, except blowout; without implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64462","name":"Pvb thoracic 2nd+ inj site","description":"Paravertebral block (pvb) (paraspinous block), thoracic; second and any additional injection site(s) (includes imaging guidance, when performed) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0406","name":"Inpt/tele follow up 15","description":"Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58275","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84140","name":"Assay of pregnenolone","description":"Pregnenolone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4102.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64736","name":"Incision of chin nerve","description":"Transection or avulsion of; mental nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95885","name":"Musc tst done w/nerv tst lim","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25929","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72194","name":"Ct pelvis w/o & w/dye","description":"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87003","name":"Small animal inoculation","description":"Animal inoculation, small animal, with observation and dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","name":"Anes ther ivntl rad ven nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2525.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KC","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33478","name":"Revision of heart chamber","description":"Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61537","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2271.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95925","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4528","name":"Adult size pull-on xl","description":"Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77055","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88107","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19307","name":"Mast mod rad","description":"Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"Office o/p new mod 45 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or excee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":140.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34843","name":"Endovasc visc aorta 3 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1394.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28540","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72127","name":"Ct neck spine w/o & w/dye","description":"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76930","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2873.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":5454.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34716","name":"Opn ax/subcla art expos cndt","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37216","name":"Transcath stent cca w/o eps","description":"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal embolic protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90653","name":"Iiv adjuvant vaccine im","description":"Influenza vaccine, inactivated (iiv), subunit, adjuvanted, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33256","name":"Ablate atria w/bypass exten","description":"Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83887","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","name":"Anes ivntl rad artl crtd/c","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0421","name":"Ed svc ckd grp per session","description":"Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37251","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64575","name":"Opn impltj nea perph nerve","description":"Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17111","name":"Destruction b9 lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44010","name":"Incision of small bowel","description":"Duodenotomy, for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96000","name":"Motion analysis video/3d","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59812","name":"Treatment of miscarriage","description":"Treatment of incomplete abortion, any trimester, completed surgically","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86079","name":"Phys blood bank serv authrj","description":"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of rh incompatible units), with written report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27027","name":"Dcmprn fasct pel compartment","description":"Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28307","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft (other than first toe)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33863","name":"Ascending aortic graft","description":"Ascending aorta graft, with cardiopulmonary bypass, with aortic root replacement using valved conduit and coronary reconstruction (eg, bentall)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2749.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92626","name":"Eval aud funcj 1st hour","description":"Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); first hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96004","name":"Phys review of motion tests","description":"Review and interpretation by physician or other qualified health care professional of comprehensive computer-based motion analysis, dynamic plantar pressure measurements, dynamic surface electromyography during walking or other functional activities, and dynamic fine wire electromyography, with writ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84485","name":"Assay duodenal fluid trypsin","description":"Trypsin; duodenal fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88304","name":"Tissue exam by pathologist","description":"Level iii - surgical pathology, gross and microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque bartholins gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel t","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3877.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11772","name":"Exc pilonidal cyst comp","description":"Excision of pilonidal cyst or sinus; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87537","name":"Hiv-2 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-2, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21387","name":"Opn tx orbit fx combined","description":"Open treatment of orbital floor blowout fracture; combined approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7679.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4855.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28055","name":"Neurectomy foot","description":"Neurectomy, intrinsic musculature of foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23172","name":"Sequestrectomy scapula","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), scapula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96440","name":"Chmotx admn plrl cav thrcnts","description":"Chemotherapy administration into pleural cavity, requiring and including thoracentesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67331","name":"Eye surgery follow-up add-on","description":"Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12041","name":"Intmd rpr n-hf/genit 2.5cm/<","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61001","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27450","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; with fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58800","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31296","name":"Nsl/sins ndsc surg frnt sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522T","name":"Prgrmg dev eval wcs ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45005","name":"Drainage of rectal abscess","description":"Incision and drainage of submucosal abscess, rectum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27605","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); local anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53605","name":"Dilate urethra stricture","description":"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16035","name":"Escharotomy 1st incision","description":"Escharotomy; initial incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19340","name":"Insj breast implt sm d mast","description":"Insertion of breast implant on same day of mastectomy (ie, immediate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47536","name":"Exchange biliary drg cath","description":"Exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96139","name":"Psycl/nrpsyc tst tech ea","description":"Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23335","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (eg, total shoulder)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5060.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69641","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42821","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; age 12 or over","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24341","name":"Rpr tdn/musc upr a/e each","description":"Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64836","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; ulnar motor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7313.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28545","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86781","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90738","name":"Inactivated je vacc im","description":"Japanese encephalitis virus vaccine, inactivated, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10180","name":"I&d complex po wound infctj","description":"Incision and drainage, complex, postoperative wound infection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84311","name":"Spectrophotometry","description":"Spectrophotometry, analyte not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34502","name":"Reconstruct vena cava","description":"Reconstruction of vena cava, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82654","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2810.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54435","name":"Revision of penis","description":"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, winter procedure, rongeur, or punch) for priapism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82542","name":"Col chromotography qual/quan","description":"Column chromatography, includes mass spectrometry, if performed (eg, hplc, lc, lc/ms, lc/ms-ms, gc, gc/ms-ms, gc/ms, hplc/ms), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41015","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78454","name":"Ht musc image planar mult","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86787","name":"Varicella-zoster antibody","description":"Antibody; varicella-zoster","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","name":"Anes c hyst flwg neuraxial","description":"Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65426","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92585","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43327","name":"Esoph fundoplasty lap","description":"Esophagogastric fundoplasty partial or complete; laparotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87490","name":"Chlmyd trach dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20560","name":"Ndl insj w/o njx 1 or 2 musc","description":"Needle insertion(s) without injection(s); 1 or 2 muscle(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83497","name":"Assay of 5-hiaa","description":"Hydroxyindolacetic acid, 5-(hiaa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4911","name":"Drain bag/bottle","description":"Drain bag/bottle, for dialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27702","name":"Reconstruct ankle joint","description":"Arthroplasty, ankle; with implant (total ankle)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33870","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35761","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":339.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0436","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","name":"Anes thoracotomy px nos","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","name":"Anes ther ivntl rad ven nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76979","name":"Us trgt dyn mbubb ea addl","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88240","name":"Cell cryopreserve/storage","description":"Cryopreservation, freezing and storage of cells, each cell line","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93609","name":"Intra-vntr mapg tchycar site","description":"Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99255","name":"Ip/obs consltj new/est hi 80","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 80 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61470","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27357","name":"Remove femur lesion/graft","description":"Excision or curettage of bone cyst or benign tumor of femur; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21480","name":"Cltx tmprmand dislc 1st/sbsq","description":"Closed treatment of temporomandibular dislocation; initial or subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95967","name":"Meg evoked each addl","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78830","name":"Rp loclzj tum spect w/ct 1","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35459","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36253","name":"Ins cath ren art 2nd+ unilat","description":"Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, an","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43456","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58672","name":"Laparoscopy fimbrioplasty","description":"Laparoscopy, surgical; with fimbrioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6086.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0642","name":"Dynamic standing frame","description":"Standing frame/table system, mobile (dynamic stander), any size including pediatric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","name":"Anes iper upr abd gstr px mo","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"Prev visit new age 5-11","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1800","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97018","name":"Paraffin bath therapy","description":"Application of a modality to 1 or more areas; paraffin bath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80184","name":"Assay of phenobarbital","description":"Phenobarbital","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23545","name":"Cltx acromclav dislc w/mnpj","description":"Closed treatment of acromioclavicular dislocation; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21145","name":"Rcnstj mdfc lefort i 1 w/grf","description":"Reconstruction midface, lefort i; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2169.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44369","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84620","name":"Xylose tolerance test","description":"Xylose absorption test, blood and/or urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88332","name":"Path consltj surg ea add blk","description":"Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34717","name":"Evasc rpr a-iliac ndgft","description":"Endovascular repair of iliac artery at the time of aorto-iliac artery endograft placement by deployment of an iliac branched endograft including pre-procedure sizing and device selection, all ipsilateral selective iliac artery catheterization(s), all associated radiological supervision and interpret","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4090.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57296","name":"Revise vag graft open abd","description":"Revision (including removal) of prosthetic vaginal graft; open abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1467.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64449","name":"Njx aa&/strd lmbr plex nfs","description":"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63077","name":"Spine disk surgery thorax","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1327.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23462","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with coracoid process transfer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43214","name":"Esophagosc dilate balloon 30","description":"Esophagoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3817.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":230.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33255","name":"Ablate atria w/o bypass ext","description":"Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4224","name":"Parenteral administration ki","description":"Parenteral nutrition administration kit, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72197","name":"Mri pelvis w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49585","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15945","name":"Exc isch pr ulc skn flp ostc","description":"Excision, ischial pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96420","name":"Chemo ia push tecnique","description":"Chemotherapy administration, intra-arterial; push technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88166","name":"Cytopath tbs c/v auto redo","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and computer-assisted rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0499","name":"Hepb screen high risk indiv","description":"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag re","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44950","name":"Appendectomy","description":"Appendectomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88350","name":"Imfluor ea addl 1antb stn px","description":"Immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27615","name":"Resect leg/ankle tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of leg or ankle area; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28299","name":"Cor hlx vlgs double osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81327","name":"Sept9 gen prmtr mthyltn alys","description":"Sept9 (septin9) (eg, colorectal cancer) promoter methylation analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35870","name":"Repair vessel graft defect","description":"Repair of graft-enteric fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27656","name":"Repair leg fascia defect","description":"Repair, fascial defect of leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30903","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73718","name":"Mri lower extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27066","name":"Remove hip bone les deep","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; deep (subfascial), includes autograft, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37722","name":"Lig div&strpg long saph vein","description":"Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75893","name":"Venous sampling by catheter","description":"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2067.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83892","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37660","name":"Ligation common iliac vein","description":"Ligation of common iliac vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94777","name":"Ped home apnea mntr rvw i&r","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; review, interpretation and preparation of report only by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26496","name":"Revise thumb tendon","description":"Opponensplasty; other methods","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94002","name":"Vent mgmt inpat init day","description":"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51590","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1569.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83951","name":"Oncoprotein dcp","description":"Oncoprotein; des-gamma-carboxy-prothrombin (dcp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64772","name":"Incision of spinal nerve","description":"Transection or avulsion of other spinal nerve, extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26255","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3214","name":"Benesch boot pair junior","description":"Benesch boot, pair, junior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3532.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22114","name":"Remove part lumbar vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","QB","NU","QF","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15777","name":"Acellular derm matrix implt","description":"Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (ie, breast, trunk) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21215","name":"Lower jaw bone graft","description":"Graft, bone; mandible (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3321.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","name":"Anes opn/arthrs knee jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0213T","name":"Njx paravert w/us cer/thor","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86769","name":"Sars-cov-2 covid-19 antibody","description":"Antibody; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","name":"Anes all px nrv musc upr leg","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61605","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1783.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59050","name":"Fetal monitor w/report","description":"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66505","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93542","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74221","name":"X-ray xm esophagus 2cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1760","name":"Closure dev, vasc","description":"Closure device, vascular (implantable/insertable)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49327","name":"Lap ins device for rt","description":"Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (list separately in addition to code for primary proced","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77772","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21084","name":"Impres&prep sp aid prosth","description":"Impression and custom preparation; speech aid prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","name":"Anes trurl px urtrl cal rmvl","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80202","name":"Assay of vancomycin","description":"Vancomycin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61711","name":"Fusion of skull arteries","description":"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63042","name":"Laminotomy single lumbar","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1142.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4343.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55530","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1773.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20552","name":"Njx 1/mlt trigger point 1/2","description":"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","name":"Anes male gent undscnd tstis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27524","name":"Treat kneecap fracture","description":"Open treatment of patellar fracture, with internal fixation and/or partial or complete patellectomy and soft tissue repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4244","name":"Alcohol or peroxide per pint","description":"Alcohol or peroxide, per pint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88350","name":"Imfluor ea addl 1antb stn px","description":"Immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11721","name":"Debride nail 6 or more","description":"Debridement of nail(s) by any method(s); 6 or more","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93527","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36215","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83632","name":"Placental lactogen","description":"Lactogen, human placental (hpl) human chorionic somatomammotropin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77051","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76885","name":"Us exam infant hips dynamic","description":"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00561","name":"Anes px heart w/pump<1 yr","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year of age","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26775","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36903","name":"Intro cath dialysis circuit","description":"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous out","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21138","name":"Rdctj forehead cntrg&prostc","description":"Reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77403","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61545","name":"Excision of brain tumor","description":"Craniotomy with elevation of bone flap; for excision of craniopharyngioma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2940.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8387.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67850","name":"Dstrj lesion lid margin <1cm","description":"Destruction of lesion of lid margin (up to 1 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55876","name":"Place rt device/marker pros","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29825","name":"Sho arthrs srg lss&rescj ads","description":"Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41006","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0274","name":"Over-bed table","description":"Over-bed table","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22525","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11622","name":"Exc s/n/h/f/g mal+mrg 1.1-2","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90804","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50340","name":"Recipient nephrectomy","description":"Recipient nephrectomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L2770","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","21","49","02","65","81","32","11","24","22","33","10","13","12","31"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67922","name":"Repair eyelid defect","description":"Repair of entropion; thermocauterization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93890","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55150","name":"Removal of scrotum","description":"Resection of scrotum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21151","name":"Rcnstj mdfc lefrtii w/b1 grf","description":"Reconstruction midface, lefort ii; any direction, requiring bone grafts (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1479.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41530","name":"Tongue base vol reduction","description":"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69005","name":"Drg xtrnl ear absc/hem comp","description":"Drainage external ear, abscess or hematoma; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78804","name":"Rp loclzj tum whbdy 2+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8170.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11047","name":"Dbrdmt bone each addl","description":"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86684","name":"Hemophilus influenza antibdy","description":"Antibody; haemophilus influenza","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5020.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64712","name":"Revision of sciatic nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5419.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49450","name":"Replace g/c tube perc","description":"Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31755","name":"Trachplsty trchphryngl fstlj","description":"Tracheoplasty; tracheopharyngeal fistulization, each stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2530.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28735","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":6455.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25126","name":"Remove/graft forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33853","name":"Rpr hypopl a-arch w/byp","description":"Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1591.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71021","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88120","name":"Cytp urne 3-5 probes ea spec","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11406","name":"Exc tr-ext b9+marg >4.0 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"Prev visit est age 40-64","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83719","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; vldl cholesterol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15650","name":"Transfer skin pedicle flap","description":"Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, walking tube), any location","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52285","name":"Cystoscopy and treatment","description":"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and fulguration of polyp(s) of urethra, bladder neck, and/or ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57260","name":"Cmbn ant pst colprhy","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55200","name":"Incision of sperm duct","description":"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46730","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; perineal or sacroperineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36909","name":"Dialysis circuit embolj","description":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation necessary to complete the intervention (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"Prev visit est age 18-39","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0438","name":"Ppps, initial visit","description":"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40702","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21495","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KM","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93318","name":"Echo transesophageal intraop","description":"Echocardiography, transesophageal (tee) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77435","name":"Sbrt management","description":"Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25300","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; flexors of fingers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","name":"Anes opn px upr tib fib&/pat","description":"Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64734","name":"Incision of cheek nerve","description":"Transection or avulsion of; infraorbital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44625","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45520","name":"Treatment of rectal prolapse","description":"Perirectal injection of sclerosing solution for prolapse","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90875","name":"Psychophysiological therapy","description":"Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21088","name":"Impres&prep facial prosth","description":"Impression and custom preparation; facial prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11960","name":"Insert tissue expander(s)","description":"Insertion of tissue expander(s) for other than breast, including subsequent expansion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88368","name":"Insitu hybridization manual","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2150.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61640","name":"Dilate ic vasospasm init","description":"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92597","name":"Oral speech device eval","description":"Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56605","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); 1 lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69950","name":"Incise inner ear nerve","description":"Vestibular nerve section, transcranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1427.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64721","name":"Carpal tunnel surgery","description":"Neuroplasty and/or transposition; median nerve at carpal tunnel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83550","name":"Iron binding test","description":"Iron binding capacity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46930","name":"Destroy internal hemorrhoids","description":"Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49507","name":"Prp i/hern init block >5 yr","description":"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95712","name":"Veeg 2-12 hr intmt mntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, 2-12 hours; with intermittent monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12001","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68801","name":"Dilate tear duct opening","description":"Dilation of lacrimal punctum, with or without irrigation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87451","name":"Polyvalent mult org ea ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; polyvalent for multiple organisms, each polyvalent antiserum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95886","name":"Musc test done w/n test comp","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50081","name":"Perq nl/pl lithotrp cplx>2cm","description":"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; complex (eg, stone[s] > 2 cm, branching stones, stones in multiple locations, ureter stones, co","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21235","name":"Ear cartilage graft","description":"Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85362","name":"Fibrin degradation products","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); agglutination slide, semiquantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0102T","name":"Esw phy anes lat hmrl epcndl","description":"Extracorporeal shock wave performed by a physician, requiring anesthesia other than local, and involving the lateral humeral epicondyle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81180","name":"Atxn3 gene detc abnor allele","description":"Atxn3 (ataxin 3) (eg, spinocerebellar ataxia, machado-joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1894","name":"Intro/sheath, non-laser","description":"Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84466","name":"Assay of transferrin","description":"Transferrin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95800","name":"Slp stdy unattended","description":"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50384","name":"Remove ureter stent percut","description":"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92627","name":"Eval aud funcj ea addl 15","description":"Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58563","name":"Hysteroscopy ablation","description":"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1219.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92548","name":"Cdp-sot 6 cond w/i&r","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73503","name":"X-ray exam hip uni 4/> views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0306","name":"Cbc/diffwbc w/o platelet","description":"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32215","name":"Treat chest lining","description":"Pleural scarification for repeat pneumothorax","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46762","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11772","name":"Exc pilonidal cyst comp","description":"Excision of pilonidal cyst or sinus; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73720","name":"Mri lwr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28305","name":"Incise/graft midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus; with autograft (includes obtaining graft) (eg, fowler type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50580","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"Esrd svc pr day pt <2","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37192","name":"Redo endovas vena cava filtr","description":"Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92924","name":"Prq trluml c athrc 1 art&/br","description":"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44133","name":"Enterectomy live donor","description":"Donor enterectomy (including cold preservation), open; partial, from living donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9986","name":"Remote e/m est. pt 40mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","name":"Anes lwr intst ndsc nos","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22521","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65091","name":"Revise eye","description":"Evisceration of ocular contents; without implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43235","name":"Egd diagnostic brush wash","description":"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27604","name":"Drain lower leg bursa","description":"Incision and drainage, leg or ankle; infected bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77032","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97605","name":"Neg prs wnd ther dme<=50sqcm","description":"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (dme), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84153","name":"Assay of psa total","description":"Prostate specific antigen (psa); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10060","name":"I&d abscess simple/single","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46910","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85461","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; rosette","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48540","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; roux-en-y","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2232.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35585","name":"Vein byp fem-tibial peroneal","description":"In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1478.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19371","name":"Peri-implt capslc brst compl","description":"Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92607","name":"Ex for speech device rx 1hr","description":"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39000","name":"Exploration of chest","description":"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88312","name":"Special stains group 1","description":"Special stain including interpretation and report; group i for microorganisms (eg, acid fast, methenamine silver)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38794","name":"Access thoracic lymph duct","description":"Cannulation, thoracic duct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59871","name":"Remove cerclage suture","description":"Removal of cerclage suture under anesthesia (other than local)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32507","name":"Wedge resect of lung diag","description":"Thoracotomy; with diagnostic wedge resection followed by anatomic lung resection (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1607.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15732","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3288.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","name":"Anes open/arthr ntrthrc amp","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; interthoracoscapular (forequarter) amputation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85370","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21705","name":"Revision of neck muscle/rib","description":"Division of scalenus anticus; with resection of cervical rib","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54312","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45382","name":"Colonoscopy w/control bleed","description":"Colonoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29883","name":"Arthrs kne srg mnisc rpr m&l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial and lateral)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93050","name":"Art pressure waveform analys","description":"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity art","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3479.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0151T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74270","name":"X-ray xm colon 1cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20500","name":"Njx sinus tract therapeutic","description":"Injection of sinus tract; therapeutic (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3152.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9978","name":"Remote e/m new pt 10mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a problem focused history; a problem focused examination; and strai","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61686","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4382.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90959","name":"Esrd serv 1 vst p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional per mont","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86906","name":"Bld typing serologic rh phnt","description":"Blood typing, serologic; rh phenotyping, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27122","name":"Reconstruction of hip socket","description":"Acetabuloplasty; resection, femoral head (eg, girdlestone procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82658","name":"Enzyme cell activity ra","description":"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57200","name":"Repair of vagina","description":"Colporrhaphy, suture of injury of vagina (nonobstetrical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77334","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1481.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87046","name":"Stool cultr aerobic bact ea","description":"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61543","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92986","name":"Revision of aortic valve","description":"Percutaneous balloon valvuloplasty; aortic valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30906","name":"Repeat control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86355","name":"B cells total count","description":"B cells, total count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21026","name":"Excision of facial bone(s)","description":"Excision of bone (eg, for osteomyelitis or bone abscess); facial bone(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28086","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; flexor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33622","name":"Redo compl cardiac anomaly","description":"Reconstruction of complex cardiac anomaly (eg, single ventricle or hypoplastic left heart) with palliation of single ventricle with aortic outflow obstruction and aortic arch hypoplasia, creation of cavopulmonary anastomosis, and removal of right and left pulmonary bands (eg, hybrid approach stage 2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3001.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2179.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2184.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","name":"Anes px heart w/pmp crc arst","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95806","name":"Sleep study unatt&resp efft","description":"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6146.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92312","name":"Contact lens fitg aphakia ou","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, both eyes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517T","name":"Insj wcs lv both compnt pg","description":"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; both components of pulse generator (battery and transmitter) only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64493","name":"Inj paravert f jnt l/s 1 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95978","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86747","name":"Parvovirus antibody","description":"Antibody; parvovirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29836","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69840","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86832","name":"Hla class i high defin qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, individual antigen per bead methodology), hla class i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2526.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78800","name":"Rp loclzj tum 1 area 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27334","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior or posterior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33391","name":"Valvuloplasty aortic valve","description":"Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or annuloplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1995.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0213T","name":"Njx paravert w/us cer/thor","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58823","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38525","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep axillary node(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4604.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24125","name":"Exc/crtg b1 cst/tum rds agrf","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77300","name":"Radiation therapy dose plan","description":"Basic radiation dosimetry calculation, central axis depth dose calculation, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23472","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99404","name":"Prev med cnsl indiv apprx 60","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4529","name":"Ped size brief/diaper sm/med","description":"Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87557","name":"M.tuberculo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2748.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58553","name":"Laparo-vag hyst complex","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33503","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34201","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":903.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70480","name":"Ct orbit/ear/fossa w/o dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54438","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1082.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67909","name":"Revise eyelid defect","description":"Reduction of overcorrection of ptosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72197","name":"Mri pelvis w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11642","name":"Exc f/e/e/n/l mal+mrg 1.1-2","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31502","name":"Change of windpipe airway","description":"Tracheotomy tube change prior to establishment of fistula tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86606","name":"Aspergillus antibody","description":"Antibody; aspergillus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37225","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5639.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":18.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21454","name":"Optx mndblr fx xtrnl fixj","description":"Open treatment of mandibular fracture with external fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0278","name":"Iliac art angio,cardiac cath","description":"Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, inj","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2180.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28294","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42415","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4552.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87797","name":"Detect agent nos dna dir","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; direct probe technique, each organism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65114","name":"Remove eye/revise socket","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":923.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62164","name":"Remove brain tumor w/scope","description":"Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88120","name":"Cytp urne 3-5 probes ea spec","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33660","name":"Repair of heart defects","description":"Repair of incomplete or partial atrioventricular canal (ostium primum atrial septal defect), with or without atrioventricular valve repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1528.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31235","name":"Nsl/sins ndsc dx sphn sinusc","description":"Nasal/sinus endoscopy, diagnostic; with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83945","name":"Assay of oxalate","description":"Oxalate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88130","name":"Sex chromatin identification","description":"Sex chromatin identification; barr bodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83695","name":"Assay of lipoprotein(a)","description":"Lipoprotein (a)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1935.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9901","name":"Delivery/set up/dispensing","description":"Dme delivery, set up, and/or dispensing service component of another hcpcs code","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0544T","name":"Tcat mv annulus rcnstj","description":"Transcatheter mitral valve annulus reconstruction, with implantation of adjustable annulus reconstruction device, percutaneous approach including transseptal puncture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94725","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L5311","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1665.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"Review patient spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; review and interpretation only by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84480","name":"Assay triiodothyronine (t3)","description":"Triiodothyronine t3; total (tt-3)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51520","name":"Removal of bladder lesion","description":"Cystotomy; for simple excision of vesical neck (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80192","name":"Assay of procainamide","description":"Procainamide; with metabolites (eg, n-acetyl procainamide)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68550","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; involving osteotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32484","name":"Segmentectomy","description":"Removal of lung, other than pneumonectomy; single segment (segmentectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4201.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4765","name":"Dialysate conc pow per pack","description":"Dialysate concentrate, powder, additive for peritoneal dialysis, per packet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61697","name":"Brain aneurysm repr complx","description":"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3926.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20664","name":"Appl halo cranial 6+pins","description":"Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42226","name":"Lengthening of palate","description":"Lengthening of palate, and pharyngeal flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58660","name":"Laparoscopy lysis","description":"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4534","name":"Youth size pull-on","description":"Youth sized disposable incontinence product, protective underwear/pull-on, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4246","name":"Betadine/phisohex solution","description":"Betadine or phisohex solution, per pint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77326","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29844","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83634","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45500","name":"Repair of rectum","description":"Proctoplasty; for stenosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2796.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43325","name":"Revise esophagus & stomach","description":"Esophagogastric fundoplasty, with fundic patch (thal-nissen procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1139.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":544.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":274.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2169.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50976","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37193","name":"Rem endovas vena cava filter","description":"Retrieval (removal) of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28570","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0422","name":"Intens cardiac rehab w/exerc","description":"Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2465.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55706","name":"Bx prst8 ndl sat sampling","description":"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92522","name":"Evaluate speech production","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28495","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93463","name":"Drug admin & hemodynmic meas","description":"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent administration, when performed (list separately in addition to","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92370","name":"Rpr&refitg spect xcp aphakia","description":"Repair and refitting spectacles; except for aphakia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","name":"Anes all px nrv msc kne&/pop","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28190","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; subcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44144","name":"Partial removal of colon","description":"Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33217","name":"Insert 2 electrode pm-defib","description":"Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93271","name":"Ecg/monitoring and analysis","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; transmission and analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01130","name":"Anes body cast appl/revj","description":"Anesthesia for body cast application or revision","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86698","name":"Histoplasma antibody","description":"Antibody; histoplasma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30210","name":"Nasal sinus therapy","description":"Displacement therapy (proetz type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76882","name":"Us lmtd jt/fcl evl nvasc xtr","description":"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19297","name":"Place breast cath for rad","description":"Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78803","name":"Rp loclzj tum spect 1 area","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41130","name":"Partial removal of tongue","description":"Glossectomy; hemiglossectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23220","name":"Radical rescj tumor prox hum","description":"Radical resection of tumor, proximal humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52330","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68200","name":"Treat eyelid by injection","description":"Subconjunctival injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38204","name":"Bl donor search management","description":"Management of recipient hematopoietic progenitor cell donor search and cell acquisition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23078","name":"Rad rescj tum shoulder 5cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0055T","name":"Bone srgry cmptr ct/mri imag","description":"Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on ct/mri images (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43753","name":"Tx gastro intub w/asp","description":"Gastric intubation and aspiration(s) therapeutic, necessitating physicians skill (eg, for gastrointestinal hemorrhage), including lavage if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77421","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40652","name":"Rpr lip fth<half ver height","description":"Repair lip, full thickness; up to half vertical height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68505","name":"Partial removal tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2826.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24470","name":"Hemiepiphyseal arrest","description":"Hemiepiphyseal arrest (eg, cubitus varus or valgus, distal humerus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P2038","name":"Blood mucoprotein","description":"Mucoprotein, blood (seromucoid) (medical necessity procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31805","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; intrathoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7168.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10121","name":"Inc&rmvl fb subq tiss comp","description":"Incision and removal of foreign body, subcutaneous tissues; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22552","name":"Arthrd ant ntrbd cervical ea","description":"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below c2, each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":42.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32445","name":"Removal of lung extrapleural","description":"Removal of lung, pneumonectomy; extrapleural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2839.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50325","name":"Prep donor renal graft","description":"Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches, as necessary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56442","name":"Hymenotomy","description":"Hymenotomy, simple incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49555","name":"Rerepair fem hernia reduce","description":"Repair recurrent femoral hernia; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91037","name":"Esoph imped function test","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83582","name":"Assay of ketogenic steroids","description":"Ketogenic steroids, fractionation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3079.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32906","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages); with closure of bronchopleural fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1320.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1588.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","name":"Anes xtrprtl lwr abd rnl px","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","name":"Anes all px nck ndl bx thyr","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21432","name":"Optx cranfcl sep w/wiring","description":"Open treatment of craniofacial separation (lefort iii type); with wiring and/or internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95134","name":"Immntx 5 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 5 stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","name":"Anes cardiac catheterization","description":"Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include swan-ganz catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4146.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","name":"Anes lwr intst ndsc nos","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30930","name":"Ther fx nasal inf turbinate","description":"Fracture nasal inferior turbinate(s), therapeutic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88331","name":"Path consltj surg 1 blk 1spc","description":"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2182.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59072","name":"Umbilical cord occlud w/us","description":"Fetal umbilical cord occlusion, including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35351","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43621","name":"Removal of stomach","description":"Gastrectomy, total; with roux-en-y reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35474","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3037.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4648","name":"Implantable tissue marker","description":"Tissue marker, implantable, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","name":"Anes 2&3 burn 4-9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; between 4% and 9% of total body surface area","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42305","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6261","name":"Wound filler gel/paste /oz","description":"Wound filler, gel/paste, per fluid ounce, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61512","name":"Crnec treph exc mngioma sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2344.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87901","name":"Nfct agt gntyp alys hiv1 rev","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hiv-1, reverse transcriptase and protease regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26500","name":"Hand tendon reconstruction","description":"Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34970.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83914","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47720","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; direct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50541","name":"Laparo ablate renal cyst","description":"Laparoscopy, surgical; ablation of renal cysts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63044","name":"Laminotomy addl lumbar","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional lumbar interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01272","name":"Anes px art femoral art lig","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery ligation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7239.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85652","name":"Rbc sed rate automated","description":"Sedimentation rate, erythrocyte; automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58554","name":"Laparo-vag hyst w/t/o compl","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77002","name":"Needle localization by xray","description":"Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85210","name":"Clot factor ii prothrom spec","description":"Clotting; factor ii, prothrombin, specific","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95925","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36823","name":"Insertion of cannula(s)","description":"Insertion of arterial and venous cannula(s) for isolated extracorporeal circulation including regional chemotherapy perfusion to an extremity, with or without hyperthermia, with removal of cannula(s) and repair of arteriotomy and venotomy sites","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99145","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38200","name":"Injection for spleen x-ray","description":"Injection procedure for splenoportography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57288","name":"Repair bladder defect","description":"Sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47800","name":"Reconstruction of bile ducts","description":"Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1315.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83664","name":"Lamellar bdy fetal lung","description":"Fetal lung maturity assessment; lamellar body density","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31531","name":"Laryngoscopy w/fb & op scope","description":"Laryngoscopy, direct, operative, with foreign body removal; with operating microscope or telescope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99483","name":"Assmt & care pln pt cog imp","description":"Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements: cognition-focused evaluation including a pertinent history and examination, m","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92605","name":"Ex for nonspeech device rx","description":"Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97035","name":"App mdlty 1+ultrasound ea 15","description":"Application of a modality to 1 or more areas; ultrasound, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15788","name":"Chemical peel facial epidrm","description":"Chemical peel, facial; epidermal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78452","name":"Ht muscle image spect mult","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or red","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33221","name":"Insert pulse gen mult leads","description":"Insertion of pacemaker pulse generator only; with existing multiple leads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3262.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"Init pm e/m new pat 1-4 yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21142","name":"Rcnstj midface lefort i 2pcs","description":"Reconstruction midface, lefort i; 2 pieces, segment movement in any direction, without bone graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37244","name":"Vasc embolize/occlude bleed","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial or venous hemorrhage or lymphatic extravasation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3506.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7300.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","name":"Anes all px nck ndl bx thyr","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73502","name":"X-ray exam hip uni 2-3 views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70542","name":"Mri orbit/face/neck w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1431.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82163","name":"Assay of angiotensin ii","description":"Angiotensin ii","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35188","name":"Rpr acq av fistula head&neck","description":"Repair, acquired or traumatic arteriovenous fistula; head and neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62264","name":"Epidural lysis on single day","description":"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92607","name":"Ex for speech device rx 1hr","description":"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3604.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","name":"Anes art f/arm wrst&hnd nos","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47130","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total right lobectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2771.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1800","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97166","name":"Ot eval mod complex 45 min","description":"Occupational therapy evaluation, moderate complexity, requiring these components: an occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy records and additional review of physical, cognitive, or psychosocial history related to current func","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75630","name":"X-ray aorta leg arteries","description":"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1571.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31610","name":"Tracheostomy fenest skin flp","description":"Tracheostomy, fenestration procedure with skin flaps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30124","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; simple, skin, subcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61609","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31526","name":"Dx laryngoscopy w/oper scope","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27768","name":"Cltx post ankle fx w/mnpj","description":"Closed treatment of posterior malleolus fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92230","name":"Fluorescein angioscopy i&r","description":"Fluorescein angioscopy with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38214","name":"Volume deplete of harvest","description":"Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68400","name":"I&d lacrimal gland","description":"Incision, drainage of lacrimal gland","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86771","name":"Shigella antibody","description":"Antibody; shigella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99328","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36558","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42815","name":"Excision of neck cyst","description":"Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11041","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91038","name":"Esoph imped funct test > 1hr","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35661","name":"Bpg femoral-femoral","description":"Bypass graft, with other than vein; femoral-femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":953.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76983","name":"Use ea addl target lesion","description":"Ultrasound, elastography; each additional target lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20240","name":"Bone biopsy open superficial","description":"Biopsy, bone, open; superficial (eg, sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28310","name":"Revision of big toe","description":"Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31641","name":"Bronchoscopy treat blockage","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (eg, laser therapy, cryotherapy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33988","name":"Insertion of left heart vent","description":"Insertion of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ecmo/ecls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65435","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10243.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0323","name":"Care manage beh svs 20mins","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following required elements: initial assessment or follow-u","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3371.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1366.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30210","name":"Nasal sinus therapy","description":"Displacement therapy (proetz type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78460","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9503","name":"Tc99m medronate","description":"Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45550","name":"Repair rectum/remove sigmoid","description":"Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81181","name":"Atxn7 gene detc abnor allele","description":"Atxn7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83925","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59030","name":"Fetal scalp blood sampling","description":"Fetal scalp blood sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42215","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; major revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["BA","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27220","name":"Treat hip socket fracture","description":"Closed treatment of acetabulum (hip socket) fracture(s); without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88741","name":"Transcutaneous methb","description":"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42107","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with local flap closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32201","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65093","name":"Revise eye with implant","description":"Evisceration of ocular contents; with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2794.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55000","name":"Drainage of hydrocele","description":"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","name":"Anes ther ivntl rad px icr","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","name":"Anes vag px crv cerclage","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27870","name":"Fusion of ankle joint open","description":"Arthrodesis, ankle, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20983","name":"Ablate bone tumor(s) perq","description":"Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; cryoablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4621.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55821","name":"Removal of prostate","description":"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6230","name":"Gauze > 48 sq in water/salne","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":207.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65730","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49425","name":"Insert abdomen-venous drain","description":"Insertion of peritoneal-venous shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15958","name":"Exc trchntr pr ulc prep ostc","description":"Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99368","name":"Team conf w/o pat by hc pro","description":"Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by nonphysician qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4987.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10009","name":"Fna bx w/ct gdn 1st les","description":"Fine needle aspiration biopsy, including ct guidance; first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37565","name":"Ligation int jugular vein","description":"Ligation, internal jugular vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50957","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54316","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1935.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0398","name":"Home sleep test/type 2 porta","description":"Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92083","name":"Extended visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, hump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61702","name":"Inner skull vessel surgery","description":"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3751.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86834","name":"Hla class i semiquant panel","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); semi-quantitative panel (eg, titer), hla class i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3000.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97171","name":"Athletic trn eval high cmplx","description":"Athletic training evaluation, high complexity, requiring these components: a medical history and physical activity profile, with 3 or more comorbidities that affect physical activity; a comprehensive examination of body systems using standardized tests and measures addressing a total of 4 or more el","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446T","name":"Insj impltbl glucose sensor","description":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation and patient training","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53515","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29445","name":"Appl rigid tot cntc leg cast","description":"Application of rigid total contact leg cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25630","name":"Cltx carpl fx w/o mnpj ea b1","description":"Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); without manipulation, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29425","name":"Appl short leg cast walking","description":"Application of short leg cast (below knee to toes); walking or ambulatory type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31255","name":"Nsl/sins ndsc w/tot ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38213","name":"Platelet deplete of harvest","description":"Transplant preparation of hematopoietic progenitor cells; platelet depletion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95805","name":"Multiple sleep latency test","description":"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99496","name":"Transj care mgmt high f2f 7d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge high level of medical decision making during the service period face-to-face visit, within 7 calenda","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0241","name":"Bath tub wall rail","description":"Bath tub wall rail, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2073.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515T","name":"Insj wcs lv compl sys","description":"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; complete system (includes electrode and generator [transmitter and battery])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86906","name":"Bld typing serologic rh phnt","description":"Blood typing, serologic; rh phenotyping, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31578","name":"Largsc w/removal lesion","description":"Laryngoscopy, flexible; with removal of lesion(s), non-laser","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41016","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59072","name":"Umbilical cord occlud w/us","description":"Fetal umbilical cord occlusion, including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17260","name":"Dstrj mal les t/a/l 0.5 cm/<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80417","name":"Renin stimulation panel","description":"Peripheral vein renin stimulation panel (eg, captopril) this panel must include the following: renin (84244 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98927","name":"Osteopath manj 5-6 regions","description":"Osteopathic manipulative treatment (omt); 5-6 body regions involved","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0209T","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold), automated; air and bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","name":"Anes px art fem art emblc","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery embolectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68330","name":"Revise eyelid lining","description":"Repair of symblepharon; conjunctivoplasty, without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83633","name":"Test urine for lactose","description":"Lactose, urine, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6218","name":"Non-sterile gauze > 48 sq in","description":"Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42972","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); with secondary surgical intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86431","name":"Rheumatoid factor quant","description":"Rheumatoid factor; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73721","name":"Mri jnt of lwr extre w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93272","name":"Ecg/review interpret only","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17437.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95801","name":"Slp stdy unatnd w/anal","description":"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59612","name":"Vbac delivery only","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28295","name":"Cor hlx vlgs prx mtar osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal metatarsal osteotomy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92070","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96360","name":"Hydration iv infusion init","description":"Intravenous infusion, hydration; initial, 31 minutes to 1 hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21348","name":"Opn tx nasomax fx w/graft","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); with bone grafting (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25118","name":"Excise wrist tendon sheath","description":"Synovectomy, extensor tendon sheath, wrist, single compartment;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19328","name":"Rmvl intact breast implant","description":"Removal of intact breast implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75573","name":"Ct hrt c+ strux cgen hrt ds","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3d image postprocessing, assessment of left ventricular [lv] cardiac function, right ventricular [rv] structure and function and evaluation of ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0013A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43198","name":"Esophagosc flex trnsn biopsy","description":"Esophagoscopy, flexible, transnasal; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49590","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81167","name":"Brca2 gene full dup/del alys","description":"Brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15786","name":"Abrasion lesion single","description":"Abrasion; single lesion (eg, keratosis, scar)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22556","name":"Arthrd ant ntrbd min dsc thc","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1467.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49405","name":"Image cath fluid colxn visc","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20660","name":"Apply rem fixation device","description":"Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43272","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45505","name":"Repair of rectum","description":"Proctoplasty; for prolapse of mucous membrane","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21121","name":"Geniop sldg osteot 1","description":"Genioplasty; sliding osteotomy, single piece","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48100","name":"Biopsy of pancreas open","description":"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51030","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38900","name":"Io map of sent lymph node","description":"Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64790","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; major peripheral nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19330","name":"Rmvl ruptured breast implant","description":"Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38900","name":"Io map of sent lymph node","description":"Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75559","name":"Cardiac mri w/stress img","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10007","name":"Fna bx w/fluor gdn 1st les","description":"Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31259","name":"Nsl/sins ndsc sphn tiss rmvl","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37202","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":369.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2358","name":"Gr 34 nonsealed leadacid","description":"Power wheelchair accessory, group 34 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33368","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71555","name":"Mri angio chest w or w/o dye","description":"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77012","name":"Ct scan for needle biopsy","description":"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93924","name":"Lwr xtr vasc stdy bilat","description":"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a st","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27360","name":"Partial removal leg bone(s)","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone, femur, proximal tibia and/or fibula (eg, osteomyelitis or bone abscess)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97130","name":"Ther ivntj ea addl 15 min","description":"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27364","name":"Resect thigh/knee tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2295.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81289","name":"Fxn gene known famil variant","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; known familial variant(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52240","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; large bladder tumor(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53502","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury, female","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2083","name":"Visit esketamine, > 56m","description":"Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","21","49","02","65","81","32","11","24","22","33","10","13","12","31"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0064A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"R0075","name":"Transport port x-ray multipl","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58573","name":"Tlh w/t/o uterus over 250 g","description":"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65286","name":"Repair of eye wound","description":"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31375","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); laterovertical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71022","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90473","name":"Immune admin oral/nasal","description":"Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82373","name":"Assay c-d transfer measure","description":"Carbohydrate deficient transferrin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97034","name":"App mdlty 1+cntrst bth ea 15","description":"Application of a modality to 1 or more areas; contrast baths, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64897","name":"Nrv grf mltst arm/leg <4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98925","name":"Osteopath manj 1-2 regions","description":"Osteopathic manipulative treatment (omt); 1-2 body regions involved","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44715","name":"Prepare donor intestine","description":"Backbench standard preparation of cadaver or living donor intestine allograft prior to transplantation, including mobilization and fashioning of the superior mesenteric artery and vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4263","name":"Permanent tear duct plug","description":"Permanent, long term, non-dissolvable lacrimal duct implant, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31571","name":"Laryngoscop w/vc inj + scope","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33223","name":"Relocate pocket for defib","description":"Relocation of skin pocket for implantable defibrillator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0283","name":"Elec stim other than wound","description":"Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29000","name":"Appl halo type body cast","description":"Application of halo type body cast (see 20661-20663 for insertion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58760","name":"Fimbrioplasty","description":"Fimbrioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43848","name":"Revj open gstr rstcv px","description":"Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1621.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57545","name":"Remove cervix/repair pelvis","description":"Excision of cervical stump, abdominal approach; with pelvic floor repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20680","name":"Removal of implant deep","description":"Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68440","name":"Snip inc lacrimal punctum","description":"Snip incision of lacrimal punctum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25628","name":"Optx carpl scphd fx int fixj","description":"Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36901","name":"Intro cath dialysis circuit","description":"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous out","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27400","name":"Revise thigh muscles/tendons","description":"Transfer, tendon or muscle, hamstrings to femur (eg, eggers type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2301.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33647","name":"Repair heart septum defects","description":"Repair of atrial septal defect and ventricular septal defect, with direct or patch closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36218","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family (list in addition to code for initial second or third order vessel as appropriate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44212","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1628.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83908","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46715","name":"Rep perf anoper fistu","description":"Repair of low imperforate anus; with anoperineal fistula (cut-back procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74363","name":"X-ray bile duct dilation","description":"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36450","name":"Bld exchange truj newborn","description":"Exchange transfusion, blood; newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74210","name":"X-ray xm phrnx&/crv esoph c+","description":"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24620","name":"Cltx monteggia fx dislc elbw","description":"Closed treatment of monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2053.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61690","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2000.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69440","name":"Exploration of middle ear","description":"Middle ear exploration through postauricular or ear canal incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31651","name":"Bronchial valve addl insert","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73225","name":"Mr angio upr extr w/o&w/dye","description":"Magnetic resonance angiography, upper extremity, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26700","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","name":"Anes 2&3 burn less 4 % tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; less than 4% total body surface area","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60225","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP20","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78072","name":"Parathyrd planar w/spect&ct","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect), and concurrently acquired computed tomography (ct) for anatomical localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88363","name":"Xm archive tissue molec anal","description":"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83704","name":"Lipoprotein bld quan part","description":"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44386","name":"Endoscopy bowel pouch/biop","description":"Endoscopic evaluation of small intestinal pouch (eg, kock pouch, ileal reservoir [s or j]); with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89125","name":"Specimen fat stain","description":"Fat stain, feces, urine, or respiratory secretions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24153","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83883","name":"Assay nephelometry not spec","description":"Nephelometry, each analyte not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0082","name":"Care man h v ext pt 30 m","description":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37183","name":"Revision tips","description":"Revision of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract recannulization/dilatation, stent placement and all associated imaging guidance and documentation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66183","name":"Insert ant drainage device","description":"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63290","name":"Bx/exc xdrl/idrl lsn any lvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2570.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2251","name":"Brief chkin, 5-10, non-e/m","description":"Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43201","name":"Esoph scope w/submucous inj","description":"Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25600","name":"Cltx dst rdl fx/ephys sep wo","description":"Closed treatment of distal radial fracture (eg, colles or smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47802","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76983","name":"Use ea addl target lesion","description":"Ultrasound, elastography; each additional target lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11022.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92997","name":"Pul art balloon repr percut","description":"Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76886","name":"Us exam infant hips static","description":"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29837","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9282","name":"Wig any type","description":"Wig, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64612","name":"Destroy nerve face muscle","description":"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36819","name":"Av fuse uppr arm basilic","description":"Arteriovenous anastomosis, open; by upper arm basilic vein transposition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92519","name":"Vemp tst i&r cervical&ocular","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; cervical (cvemp) and ocular (ovemp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0110T","name":"Nos quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using other stimuli to assess sensation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81233","name":"Btk gene common variants","description":"Btk (brutons tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, c481s, c481r, c481f)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97116","name":"Gait training therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21046","name":"Remove mandible cyst complex","description":"Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67909","name":"Revise eyelid defect","description":"Reduction of overcorrection of ptosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90804","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2808.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0182","name":"Hospice care supervision","description":"Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other stu","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49650","name":"Lap ing hernia repair init","description":"Laparoscopy, surgical; repair initial inguinal hernia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","name":"Anes px crv spn&cord sitting","description":"Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83070","name":"Assay of hemosiderin qual","description":"Hemosiderin, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30118","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; external approach (lateral rhinotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99310","name":"Sbsq nf care high mdm 45","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65280","name":"Repair of eye wound","description":"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28415","name":"Optx calcaneal fracture","description":"Open treatment of calcaneal fracture, includes internal fixation, when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30905","name":"Control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89141","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39541","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21440","name":"Cltx mndblr/max alv ridge fx","description":"Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26489","name":"Transplant/graft palm tendon","description":"Transfer or transplant of tendon, palmar; with free tendon graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1894","name":"Intro/sheath, non-laser","description":"Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33768","name":"Anast cavopulm sec sup v/c","description":"Anastomosis, cavopulmonary, second superior vena cava (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52442","name":"Cysto ins trnsprstc implt ea","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6284.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53449","name":"Repair uro sphincter","description":"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99407","name":"Behav chng smoking > 10 min","description":"Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57291","name":"Construction of vagina","description":"Construction of artificial vagina; without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78708","name":"K flow/funct image w/drug","description":"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10006","name":"Fna bx w/us gdn ea addl","description":"Fine needle aspiration biopsy, including ultrasound guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9869","name":"Cmmi asyntelehealth 10-20min","description":"Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, 10-20 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63621","name":"Srs spinal lesion addl","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":83.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84087","name":"Assay phosphohexose enzymes","description":"Phosphohexose isomerase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37248","name":"Trluml balo angiop 1st vein","description":"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23035","name":"Incision bone cortex sho","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), shoulder area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25530","name":"Cltx ulnar shft fx w/o mnpj","description":"Closed treatment of ulnar shaft fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61563","name":"Excision of skull tumor","description":"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25810","name":"Arthrd wrst iliac/oth agrft","description":"Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41116","name":"Excision of mouth lesion","description":"Excision, lesion of floor of mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50323","name":"Prep cadaver renal allograft","description":"Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision of adrenal gland, and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87324","name":"Clostridium ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; clostridium difficile toxin(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64870","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2757.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2332.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62324","name":"Njx interlaminar crv/thrc","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thorac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33692","name":"Comp rpr tof wo pulm atresia","description":"Complete repair tetralogy of fallot without pulmonary atresia;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24362","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with implant and fascia lata ligament reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4997.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26525","name":"Release finger contracture","description":"Capsulectomy or capsulotomy; interphalangeal joint, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68840","name":"Explore/irrigate tear ducts","description":"Probing of lacrimal canaliculi, with or without irrigation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28406","name":"Prq skel fix clcnl fx w/mnpj","description":"Percutaneous skeletal fixation of calcaneal fracture, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0400","name":"Home sleep test/type 4 porta","description":"Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64408","name":"Njx aa&/strd vagus nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; vagus nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3219","name":"Orthopedic mens shoes oxford","description":"Orthopedic footwear, mens shoe, oxford, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11005","name":"Dbrdmt skin abdominal wall","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; abdominal wall, with or without fascial closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27290","name":"Amputation of leg at hip","description":"Interpelviabdominal amputation (hindquarter amputation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88175","name":"Cytopath c/v auto fluid redo","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87305","name":"Aspergillus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; aspergillus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74283","name":"Ther nma rdctj intus/obstrcj","description":"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46760","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; muscle transplant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6978.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87497","name":"Cytomeg dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6013","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4301","name":"Implantable access syst perc","description":"Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43330","name":"Esophagomyotomy abdominal","description":"Esophagomyotomy (heller type); abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1119.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44800","name":"Excision of bowel pouch","description":"Excision of meckels diverticulum (diverticulectomy) or omphalomesenteric duct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10440.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21215","name":"Lower jaw bone graft","description":"Graft, bone; mandible (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26426","name":"Repair finger/hand tendon","description":"Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); using local tissue(s), including lateral band(s), each finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41820","name":"Excision gum each quadrant","description":"Gingivectomy, excision gingiva, each quadrant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68720","name":"Create tear sac drain","description":"Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7928.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0202U","name":"Nfct ds 22 trgt sars-cov-2","description":"Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (dna or rna), 22 targets including severe acute respiratory syndrome coronavirus 2 (sars-cov-2), qualitative rt-pcr, nasopharyngeal swab, each pathogen reported as detected or not detected","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27438","name":"Revise kneecap with implant","description":"Arthroplasty, patella; with prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87300","name":"Ag detection polyval if","description":"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95923","name":"Autonomic nrv syst funj test","description":"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4680.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26645","name":"Treat thumb fracture","description":"Closed treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27130","name":"Total hip arthroplasty","description":"Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1150.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88167","name":"Cytopath tbs c/v select","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82248","name":"Bilirubin direct","description":"Bilirubin; direct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84545","name":"Urea-n clearance test","description":"Urea nitrogen, clearance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1431.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1510.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68850","name":"Injection for tear sac x-ray","description":"Injection of contrast medium for dacryocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35361","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43279","name":"Lap myotomy heller","description":"Laparoscopy, surgical, esophagomyotomy (heller type), with fundoplasty, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29895","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86688","name":"Htlv-ii antibody","description":"Antibody; htlv-ii","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93453","name":"R&l hrt cath w/ventriclgrphy","description":"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27226","name":"Treat hip wall fracture","description":"Open treatment of posterior or anterior acetabular wall fracture, with internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24344","name":"Reconstruct elbow lat ligmnt","description":"Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45800","name":"Repair rect/bladder fistula","description":"Closure of rectovesical fistula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5097.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76706","name":"Us abdl aorta screen aaa","description":"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (aaa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82261","name":"Assay of biotinidase","description":"Biotinidase, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33891","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59012","name":"Fetal cord puncture prenatal","description":"Cordocentesis (intrauterine), any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57107","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22800","name":"Arthrd pst dfrm<6 vrt sgm","description":"Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1186.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31300","name":"Removal of larynx lesion","description":"Laryngotomy (thyrotomy, laryngofissure), with removal of tumor or laryngocele, cordectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":948.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61105","name":"Tdh sdrl/ventr pnxr","description":"Twist drill hole for subdural or ventricular puncture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67420","name":"Explore/treat eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38510","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep cervical node(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15774","name":"Gfrg autol fat lipo ea addl","description":"Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3257.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P2038","name":"Blood mucoprotein","description":"Mucoprotein, blood (seromucoid) (medical necessity procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11982.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27079","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41874","name":"Alveoloplasty each quadrant","description":"Alveoloplasty, each quadrant (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90840","name":"Psytx crisis ea addl 30 min","description":"Psychotherapy for crisis; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23222","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1268.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14300","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KC","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29828","name":"Sho arthrs srg bicp tenodsis","description":"Arthroscopy, shoulder, surgical; biceps tenodesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92286","name":"Ant sgm img i&r speclr mic","description":"Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0315","name":"Counsel immune <21 5-15 m","description":"Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5225.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21015","name":"Resect face/scalp tum < 2 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; less than 2 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49326","name":"Lap w/omentopexy add-on","description":"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49572","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36430","name":"Transfusion bld/bld compnt","description":"Transfusion, blood or blood components","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87620","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80435","name":"Insulin tolerance panel","description":"Insulin tolerance panel; for growth hormone deficiency this panel must include the following: glucose (82947 x 5) human growth hormone (hgh) (83003 x 5)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50782","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of duplicated ureter to bladder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42507","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74183","name":"Mri abd w/o cntr flwd cntr","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4223","name":"Infusion supplies w/o pump","description":"Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33917","name":"Repair pulmonary artery","description":"Repair of pulmonary artery stenosis by reconstruction with patch or graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81174","name":"Ar gene known famil variant","description":"Ar (androgen receptor) (eg, spinal and bulbar muscular atrophy, kennedy disease, x chromosome inactivation) gene analysis; known familial variant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92516","name":"Facial nerve function test","description":"Facial nerve function studies (eg, electroneuronography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33813","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88361","name":"Tumor immunohistochem/comput","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12004","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74262","name":"Ct colonography dx w/dye","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29863","name":"Hip arthr0 w/synovectomy","description":"Arthroscopy, hip, surgical; with synovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65780","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25685","name":"Optx trns-scphprlnr fx dislc","description":"Open treatment of trans-scaphoperilunar type of fracture dislocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":497.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67808","name":"Remove eyelid lesion(s)","description":"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50725","name":"Release/revise ureter","description":"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0071A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31554","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, with indwelling stent placement, age 12 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1206.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27218","name":"Treat pelvic ring fracture","description":"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes ipsilateral ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62280","name":"Treat spinal cord lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27059","name":"Resect hip/pelv tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52214","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68760","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1892.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84156","name":"Assay of protein urine","description":"Protein, total, except by refractometry; urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86226","name":"Dna antibody single strand","description":"Deoxyribonucleic acid (dna) antibody; single stranded","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21436","name":"Optx crnfcl sep comp mlt int","description":"Open treatment of craniofacial separation (lefort iii type); complicated, multiple surgical approaches, internal fixation, with bone grafting (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23430","name":"Repair biceps tendon","description":"Tenodesis of long tendon of biceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36907","name":"Balo angiop ctr dialysis seg","description":"Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplasty (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27507","name":"Treatment of thigh fracture","description":"Open treatment of femoral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99402","name":"Prev med cnsl indiv apprx 30","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3350.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4208","name":"3 cc sterile syringe&needle","description":"Syringe with needle, sterile 3 cc, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33608","name":"Repair anomaly w/conduit","description":"Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal defect by construction or replacement of conduit from right or left ventricle to pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86762","name":"Rubella antibody","description":"Antibody; rubella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AV"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35700","name":"Reoperation bypass graft","description":"Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4532","name":"Ped size pull-on lg","description":"Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83018","name":"Heavy metal quan each nes","description":"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92342","name":"Fit spectacles multifocal","description":"Fitting of spectacles, except for aphakia; multifocal, other than bifocal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5020.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37232","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8644.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43755","name":"Dx gastr intub w/asp specs","description":"Gastric intubation and aspiration, diagnostic; collection of multiple fractional specimens with gastric stimulation, single or double lumen tube (gastric secretory study) (eg, histamine, insulin, pentagastrin, calcium, secretin), includes drug administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28636","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01936","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576T","name":"Interrog dev eval icds ss ip","description":"Interrogation device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7671.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33263","name":"Rmvl & rplcmt dfb gen 2 lead","description":"Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; dual lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88177","name":"Cytp fna eval ea addl","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4670","name":"Automatic bp monitor, dial","description":"Automatic blood pressure monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86225","name":"Dna antibody native","description":"Deoxyribonucleic acid (dna) antibody; native or double stranded","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25215","name":"Removal of wrist bones","description":"Carpectomy; all bones of proximal row","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80201","name":"Assay of topiramate","description":"Topiramate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68110","name":"Exc les conjunctiva <1 cm","description":"Excision of lesion, conjunctiva; up to 1 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20553","name":"Njx 1/mlt trigger points 3/>","description":"Injection(s); single or multiple trigger point(s), 3 or more muscles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46610","name":"Anoscopy remove lesion","description":"Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61534","name":"Removal of brain lesion","description":"Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10021","name":"Fna bx w/o img gdn 1st les","description":"Fine needle aspiration biopsy, without imaging guidance; first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9552","name":"F18 fdg","description":"Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24077","name":"Rad rescj tum tiss a/e <5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27303","name":"Drainage of bone lesion","description":"Incision, deep, with opening of bone cortex, femur or knee (eg, osteomyelitis or bone abscess)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21080","name":"Impres&prep def obt prosth","description":"Impression and custom preparation; definitive obturator prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67227","name":"Dstrj extensive retinopathy","description":"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54000","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2039.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27328","name":"Exc thigh/knee tum deep <5cm","description":"Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26478","name":"Lengthening of hand tendon","description":"Lengthening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3649","name":"Orthopedic shoe modifica nos","description":"Orthopedic shoe, modification, addition or transfer, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64447","name":"Njx aa&/strd femoral nrv img","description":"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63615","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33025","name":"Incision of heart sac","description":"Creation of pericardial window or partial resection for drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1870.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11042","name":"Dbrdmt subq tis 1st 20sqcm/<","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72148","name":"Mri lumbar spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86060","name":"Antistreptolysin o titer","description":"Antistreptolysin 0; titer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87912","name":"Nfct agt gntyp alys hep b","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hepatitis b virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61584","name":"Orbitocranial approach/skull","description":"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2584.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2340.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33770","name":"Rpr tga w/o surg enlgmnt vsd","description":"Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; without surgical enlargement of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29105","name":"Application long arm splint","description":"Application of long arm splint (shoulder to hand)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63600","name":"Remove spinal cord lesion","description":"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01470","name":"Anes px nrv msc lw l/a/f nos","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25101","name":"Explore/treat wrist joint","description":"Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86243","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57415","name":"Remove vaginal foreign body","description":"Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4340.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27385","name":"Repair of thigh muscle","description":"Suture of quadriceps or hamstring muscle rupture; primary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80053","name":"Comprehen metabolic panel","description":"Comprehensive metabolic panel this panel must include the following: albumin (82040) bilirubin, total (82247) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphatase, alkaline (84075) potassium (84132) protein, total (84155) sodium ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93620","name":"Comp ep evl r at ven pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49492","name":"Rpr ing hern premie blocked","description":"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74170","name":"Ct abd wo cntrst flwd cntrst","description":"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92521","name":"Evaluation of speech fluency","description":"Evaluation of speech fluency (eg, stuttering, cluttering)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46606","name":"Anoscopy and biopsy","description":"Anoscopy; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27702","name":"Reconstruct ankle joint","description":"Arthroplasty, ankle; with implant (total ankle)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","name":"Anes thrcm px pulm rescj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8100","name":"Spacer without mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; without mask","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27540","name":"Treat knee fracture","description":"Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95125","name":"Immunotherapy 2/> injections","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 2 or more injections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43510","name":"Surgical opening of stomach","description":"Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, celestin or mousseaux-barbin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"Prev visit est age 5-11","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43256","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62322","name":"Njx interlaminar lmbr/sac","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4913.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88321","name":"Consltj&reprt sld prep elswr","description":"Consultation and report on referred slides prepared elsewhere","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96416","name":"Chemo prolong infuse w/pump","description":"Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32553","name":"Ins mark thor for rt perq","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-thoracic, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42894","name":"Revision of pharyngeal walls","description":"Resection of pharyngeal wall requiring closure with myocutaneous or fasciocutaneous flap or free muscle, skin, or fascial flap with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97130","name":"Ther ivntj ea addl 15 min","description":"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52334","name":"Create passage to kidney","description":"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86788","name":"West nile virus ab igm","description":"Antibody; west nile virus, igm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83570","name":"Assay of idh enzyme","description":"Isocitric dehydrogenase (idh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93985","name":"Dup-scan hemo compl bi std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26841","name":"Fusion of thumb","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73550","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43330","name":"Esophagomyotomy abdominal","description":"Esophagomyotomy (heller type); abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1119.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31636","name":"Bronchoscopy bronch stents","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of bronchial stent(s) (includes tracheal/bronchial dilation as required), initial bronchus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22614","name":"Arthrd pst tq 1ntrspc ea add","description":"Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11055","name":"Paring/cutg b9 hyprker les 1","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35512","name":"Art byp grft subclav-brchial","description":"Bypass graft, with vein; subclavian-brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523T","name":"Ntrapx c ffr w/3d funcjl map","description":"Intraprocedural coronary fractional flow reserve (ffr) with 3d functional mapping of color-coded ffr values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention (list separately in addition to code ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45303","name":"Proctosigmoidoscopy dilate","description":"Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33724","name":"Repair venous anomaly","description":"Repair of isolated partial anomalous pulmonary venous return (eg, scimitar syndrome)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30465","name":"Repair nasal stenosis","description":"Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21431","name":"Cltx craniofacial separation","description":"Closed treatment of craniofacial separation (lefort iii type) using interdental wire fixation of denture or splint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19361","name":"Brst rcnstj latsms drsi flap","description":"Breast reconstruction; with latissimus dorsi flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3608.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0440","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38210","name":"T-cell depletion of harvest","description":"Transplant preparation of hematopoietic progenitor cells; specific cell depletion within harvest, t-cell depletion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43245","name":"Egd dilate stricture","description":"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82042","name":"Other source albumin quan ea","description":"Albumin; other source, quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15839","name":"Exc excessive skn other area","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24164","name":"Removal prosth radial head","description":"Removal of prosthesis, includes debridement and synovectomy when performed; radial head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29044","name":"Appl bdy cst sho to hip 1thi","description":"Application of body cast, shoulder to hips; including 1 thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95832","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29581","name":"Appl multlayer cmprn sys leg","description":"Application of multi-layer compression system; leg (below knee), including ankle and foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93563","name":"Njx cgen car cth slctv c ang","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81015","name":"Microscopic exam of urine","description":"Urinalysis; microscopic only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64472","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39541","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87276","name":"Influenza a ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza a virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96360","name":"Hydration iv infusion init","description":"Intravenous infusion, hydration; initial, 31 minutes to 1 hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66711","name":"Ecp ciliary body destruction","description":"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0339","name":"Robot lin-radsurg com, first","description":"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2583.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":845.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":173.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2321.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0247","name":"Routine footcare pt w lops","description":"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wou","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82239","name":"Bile acids total","description":"Bile acids; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15336","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36581","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22511","name":"Perq lumbosacral injection","description":"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97139","name":"Unlisted therapeutic px","description":"Unlisted therapeutic procedure (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0481","name":"Intrpulmnry percuss vent sys","description":"Intrapulmonary percussive ventilation system and related accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74230","name":"X-ray xm swlng funcj c+","description":"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75563","name":"Card mri w/stress img & dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63285","name":"Bx/exc idrl imed lesn cervl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2405.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75774","name":"Artery x-ray each vessel","description":"Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4104","name":"Additive for enteral formula","description":"Additive for enteral formula (e.g., fiber)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4491.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50230","name":"Removal kidney open radical","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26230","name":"Partial removal of hand bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); metacarpal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98943","name":"Chiropract manj xtrspinl 1/>","description":"Chiropractic manipulative treatment (cmt); extraspinal, 1 or more regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11422","name":"Exc h-f-nk-sp b9+marg 1.1-2","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75564","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67412","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31578","name":"Largsc w/removal lesion","description":"Laryngoscopy, flexible; with removal of lesion(s), non-laser","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86652","name":"Encephaltis east eqne anbdy","description":"Antibody; encephalitis, eastern equine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15758","name":"Free fascial flap microvasc","description":"Free fascial flap with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28124","name":"Partial removal of toe","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); phalanx of toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","name":"Anes spine manipulation","description":"Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21077","name":"Impres&prep orbital prosth","description":"Impression and custom preparation; orbital prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36581","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47100","name":"Wedge biopsy of liver","description":"Biopsy of liver, wedge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21275","name":"Revision orbitofacial bones","description":"Secondary revision of orbitocraniofacial reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58570","name":"Tlh uterus 250 g or less","description":"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82565","name":"Assay of creatinine","description":"Creatinine; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93264","name":"Rem mntr wrls p-art prs snr","description":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days, including at least weekly downloads of pulmonary artery pressure recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25607","name":"Optx dst rd xartc fx/epi sep","description":"Open treatment of distal radial extra-articular fracture or epiphyseal separation, with internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77048","name":"Mri breast c-+ w/cad uni","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","name":"Anes ivntl rad artl crtd/c","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3202","name":"Oxford w/ supinat/pronator c","description":"Orthopedic shoe, oxford with supinator or pronator, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31628","name":"Bronchoscopy/lung bx each","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0003A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24685","name":"Optx ulnar fx prox end w/fix","description":"Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]), includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15150","name":"Tis cltr skn agrft t/a/l 1st","description":"Tissue cultured skin autograft, trunk, arms, legs; first 25 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36833","name":"Av fistula revision","description":"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11403","name":"Exc tr-ext b9+marg 2.1-3cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93624","name":"Ep f-up study pacg&rec","description":"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33390","name":"Valvuloplasty aortic valve","description":"Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; simple (ie, valvotomy, debridement, debulking, and/or simple commissural resuspension)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60220","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72146","name":"Mri chest spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","name":"Anes all px nrv msc kne&/pop","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","name":"Anes px ear w/bx nos","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50845","name":"Appendico-vesicostomy","description":"Cutaneous appendico-vesicostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72141","name":"Mri neck spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5105.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2523.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87487","name":"Chlmyd pneum dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93296","name":"Rem interrog evl pm/ids","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, leadless pacemaker system, or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33722","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1414.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","name":"Anes male gent rad orch ing","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8699.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8900","name":"Mra w/cont, abd","description":"Magnetic resonance angiography with contrast, abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48120","name":"Removal of pancreas lesion","description":"Excision of lesion of pancreas (eg, cyst, adenoma)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27829","name":"Treat lower leg joint","description":"Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22534","name":"Arthrd lat xtrcvtry tq ea ad","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic or lumbar, each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26110","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; interphalangeal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61624","name":"Tcat perm occls/embolj cns","description":"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention, percutaneous,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93790","name":"Ambl bp mntr w/sw i&r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; review with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96931","name":"Rcm img acquisj&i&r 1st les","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities: person-centered interview, performed to better understa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42836","name":"Removal of adenoids","description":"Adenoidectomy, secondary; age 12 or over","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6473.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2623.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49436","name":"Embedded ip cath exit-site","description":"Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53270","name":"Removal of urethra gland","description":"Excision or fulguration; skenes glands","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"Prev visit est age 1-4","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40801","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57065","name":"Destruction vag lesion xtnsv","description":"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99358","name":"Prolong service w/o contact","description":"Prolonged evaluation and management service before and/or after direct patient care; first hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27732","name":"Repair of fibula epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27235","name":"Treat thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, proximal end, neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93287","name":"Peri-px device eval & prgr","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26442","name":"Release palm & finger tendon","description":"Tenolysis, flexor tendon; palm and finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32609","name":"Thoracoscopy w/bx pleura","description":"Thoracoscopy; with biopsy(ies) of pleura","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35482","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0148T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73725","name":"Mr ang lwr ext w or w/o dye","description":"Magnetic resonance angiography, lower extremity, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3652","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90822","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1759.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11183.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2528.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1276.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76706","name":"Us abdl aorta screen aaa","description":"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (aaa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47741","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y with gastroenterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1237.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43250","name":"Egd cautery tumor polyp","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","name":"Anes/analg cs dlvr neuraxial","description":"Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33270","name":"Ins/rep subq defibrillator","description":"Insertion or replacement of permanent subcutaneous implantable defibrillator system, with subcutaneous electrode, including defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic param","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44381","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; with transendoscopic balloon dilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27606","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66250","name":"Follow-up surgery of eye","description":"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","name":"Anes trurl px urtrl cal rmvl","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90824","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38790","name":"Inject for lymphatic x-ray","description":"Injection procedure; lymphangiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31254","name":"Nsl/sins ndsc w/prtl ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92354","name":"Fitg spect low vis 1system","description":"Fitting of spectacle mounted low vision aid; single element system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2528.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67935","name":"Repair eyelid wound","description":"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4531","name":"Ped size pull-on sm/med","description":"Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44950","name":"Appendectomy","description":"Appendectomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22842","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2467.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27893","name":"Decompression of leg","description":"Decompression fasciotomy, leg; posterior compartment(s) only, with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45334","name":"Sigmoidoscopy for bleeding","description":"Sigmoidoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":509.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0464","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1321.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67412","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45378","name":"Diagnostic colonoscopy","description":"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86157","name":"Cold agglutinin titer","description":"Cold agglutinin; titer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84437","name":"Assay of neonatal thyroxine","description":"Thyroxine; requiring elution (eg, neonatal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87341","name":"Hep b surface ag neutrlzj ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag) neutralization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76536","name":"Us exam of head and neck","description":"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90470","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":275.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84154","name":"Assay of psa free","description":"Prostate specific antigen (psa); free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93293","name":"Pm phone r-strip device eval","description":"Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93641","name":"Ep evl 1/2chmb pac cvdfb tst","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69661","name":"Revise middle ear bone","description":"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31070","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; external, simple (trephine operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99451","name":"Ntrprof ph1/ntrnet/ehr 5/>","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a written report to the patients treating/requesting physician or other qualified health care professional, 5 mi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15155","name":"Tis cltr agrft f/s/n/h/f/g 1","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87184","name":"Sc std disk method per plate","description":"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","name":"Anes px male gent orchiopexy","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17270","name":"Dstr mal les s/n/h/f/g .5 /<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88142","name":"Cytopath c/v thin layer","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20694","name":"Rmvl ext fixj sys under anes","description":"Removal, under anesthesia, of external fixation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22870","name":"Insj stablj dev w/o dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65420","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64792","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; extensive (including malignant type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":939.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25135","name":"Remove & graft wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69644","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1194.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33403","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24138","name":"Sequestrectomy olecrn proces","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74363","name":"X-ray bile duct dilation","description":"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86658","name":"Enterovirus antibody","description":"Antibody; enterovirus (eg, coxsackie, echo, polio)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41252","name":"Repair tongue laceration","description":"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43886","name":"Gstr rstcv px opn revj port","description":"Gastric restrictive procedure, open; revision of subcutaneous port component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96150","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25393","name":"Lengthen radius & ulna","description":"Osteoplasty, radius and ulna; lengthening with autograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":956.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51729","name":"Cystometrogram w/vp&up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86695","name":"Herpes simplex type 1 test","description":"Antibody; herpes simplex, type 1","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31592","name":"Cricotracheal resection","description":"Cricotracheal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28645","name":"Repair toe dislocation","description":"Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4915.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49040","name":"Drain open abdom abscess","description":"Drainage of subdiaphragmatic or subphrenic abscess, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1811.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","name":"Anes px art lower leg emblc","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42408","name":"Excision of salivary cyst","description":"Excision of sublingual salivary cyst (ranula)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43197","name":"Esophagoscopy flex dx brush","description":"Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49651","name":"Lap ing hernia repair recur","description":"Laparoscopy, surgical; repair recurrent inguinal hernia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93514","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25085","name":"Incision of wrist capsule","description":"Capsulotomy, wrist (eg, contracture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45338","name":"Sigmoidoscopy w/tumr remove","description":"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28153","name":"Partial removal of toe","description":"Resection, condyle(s), distal end of phalanx, each toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76979","name":"Us trgt dyn mbubb ea addl","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","KL","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15274","name":"Skn sub grft t/a/l child add","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01520","name":"Anes px veins lower leg nos","description":"Anesthesia for procedures on veins of lower leg; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96020","name":"Functional brain mapping","description":"Neurofunctional testing selection and administration during noninvasive imaging functional brain mapping, with test administered entirely by a physician or other qualified health care professional (ie, psychologist), with review of test results and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83727","name":"Assay of lrh hormone","description":"Luteinizing releasing factor (lrh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69505","name":"Remove mastoid structures","description":"Mastoidectomy; modified radical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31529","name":"Laryngoscopy and dilation","description":"Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37619","name":"Ligation of inf vena cava","description":"Ligation of inferior vena cava","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1522.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90857","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73225","name":"Mr angio upr extr w/o&w/dye","description":"Magnetic resonance angiography, upper extremity, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62005","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; compound or comminuted, extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33922","name":"Transect pulmonary artery","description":"Transection of pulmonary artery with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26705","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36468","name":"Njx sclrsnt spider veins","description":"Injection(s) of sclerosant for spider veins (telangiectasia), limb or trunk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27052","name":"Biopsy of hip joint","description":"Arthrotomy, with biopsy; hip joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92961","name":"Cardioversion electric int","description":"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":325.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93583","name":"Perq transcath septal reduxn","description":"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78801","name":"Rp loclzj tum 2+area 1+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or m","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44373","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15273","name":"Skin sub grft t/arm/lg child","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51700","name":"Irrigation of bladder","description":"Bladder irrigation, simple, lavage and/or instillation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","name":"Anes/analg cs dlvr neuraxial","description":"Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17261","name":"Dstrj mal les t/a/l .6-1.0cm","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22849","name":"Reinsert spinal fixation","description":"Reinsertion of spinal fixation device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88107","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64862","name":"Repair of low back nerves","description":"Suture of; lumbar plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1167.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0212T","name":"Compre audiometry evaluation","description":"Comprehensive audiometry threshold evaluation and speech recognition (0209t, 0211t combined), automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34803","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1097.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35180","name":"Rpr cgen av fistula head&nck","description":"Repair, congenital arteriovenous fistula; head and neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99175","name":"Induction of vomiting","description":"Ipecac or similar administration for individual emesis and continued observation until stomach adequately emptied of poison","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59515","name":"Cesarean delivery","description":"Cesarean delivery only; including postpartum care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1130.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87581","name":"M.pneumon dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60280","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62161","name":"Dissect brain w/scope","description":"Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1376.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54650","name":"Orchiopexy (fowler-stephens)","description":"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, fowler-stephens)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27745","name":"Reinforce tibia","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, tibia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43631","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastroduodenostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1211.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40820","name":"Treatment of mouth lesion","description":"Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17282","name":"Dstr mal ls f/e/e/n/l/m1.1-2","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43757","name":"Dx duod intub w/asp specs","description":"Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes drug administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99149","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28110","name":"Part removal of metatarsal","description":"Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15952","name":"Exc trchntr pr ulc flp clsr","description":"Excision, trochanteric pressure ulcer, with skin flap closure;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49185","name":"Sclerotx fluid collection","description":"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15771.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67025","name":"Replace eye fluid","description":"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17855.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82544","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15851","name":"Removal sutr/staple req anes","description":"Removal of sutures or staples requiring anesthesia (ie, general anesthesia, moderate sedation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33771","name":"Rpr tga w/surg enlgmnt vsd","description":"Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; with surgical enlargement of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1900.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00860","name":"Anes xtrprtl px lwr abd nos","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50972","name":"Ureter endoscopy & catheter","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81289","name":"Fxn gene known famil variant","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; known familial variant(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4680.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22848","name":"Insert pelv fixation device","description":"Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82930","name":"Gastric analy w/ph ea spec","description":"Gastric acid analysis, includes ph if performed, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89225","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17107","name":"Dstr cut vsc prlf les10-50sq","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); 10.0 to 50.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58120","name":"Dilation and curettage","description":"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78432","name":"Myocrd img pet 2rtracer","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":16.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47490","name":"Incision of gallbladder","description":"Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when performed, and radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15150","name":"Tis cltr skn agrft t/a/l 1st","description":"Tissue cultured skin autograft, trunk, arms, legs; first 25 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22010","name":"I&d p-spine c/t/cerv-thor","description":"Incision and drainage, open, of deep abscess (subfascial), posterior spine; cervical, thoracic, or cervicothoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34710","name":"Dlyd plmt xtn prosth 1st vsl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5717.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7168.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77316","name":"Brachytx isodose plan simple","description":"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43287","name":"Esphg dstl 2/3 w/laps moblj","description":"Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic e","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3003.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70549","name":"Mr angiograph neck w/o&w/dye","description":"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45121","name":"Removal of rectum and colon","description":"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with subtotal or total colectomy, with multiple biopsies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1462.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83080","name":"Assay of b hexosaminidase ea","description":"B-hexosaminidase, each assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20912","name":"Remove cartilage for graft","description":"Cartilage graft; nasal septum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33993","name":"Reposg perq r/l hrt vad","description":"Repositioning of percutaneous right or left heart ventricular assist device with imaging guidance at separate and distinct session from insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80069","name":"Renal function panel","description":"Renal function panel this panel must include the following: albumin (82040) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphorus inorganic (phosphate) (84100) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29035","name":"Appl body cast sho to hips","description":"Application of body cast, shoulder to hips;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","name":"Anes px fcl b1/skl rad surg","description":"Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1154.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84081","name":"Assay phosphatidylglycerol","description":"Phosphatidylglycerol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82331","name":"Calcium infusion test","description":"Calcium; after calcium infusion test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84022","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2994.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35800","name":"Explore neck vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43332","name":"Transab esoph hiat hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83722","name":"Lipoprtn dir meas sd ldl chl","description":"Lipoprotein, direct measurement; small dense ldl cholesterol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93985","name":"Dup-scan hemo compl bi std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33405","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1973.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90740","name":"Hepb vacc 3 dose immunsup im","description":"Hepatitis b vaccine (hepb), dialysis or immunosuppressed patient dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11642","name":"Exc f/e/e/n/l mal+mrg 1.1-2","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25125","name":"Remove/graft forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93314","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4530","name":"Ped size brief/diaper lg","description":"Pediatric sized disposable incontinence product, brief/diaper, large size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43621","name":"Removal of stomach","description":"Gastrectomy, total; with roux-en-y reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21502","name":"I&d dp abs/hmtm nck rib ostc","description":"Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax; with partial rib ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0310","name":"Immunize counsel 5-15 min","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50845","name":"Appendico-vesicostomy","description":"Cutaneous appendico-vesicostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0878","name":"Pwc gp4 std sing pow opt cap","description":"Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35665","name":"Bpg iliofemoral","description":"Bypass graft, with other than vein; iliofemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43020","name":"Incision of esophagus","description":"Esophagotomy, cervical approach, with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26373","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; secondary without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96570","name":"Photodynmc tx 30 min add-on","description":"Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (list separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83857","name":"Assay of methemalbumin","description":"Methemalbumin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29085","name":"Appl cast hand&lwr forearm","description":"Application, cast; hand and lower forearm (gauntlet)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67912","name":"Correction eyelid w/implant","description":"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1760.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5892.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":11183.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9982.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45321","name":"Proctosigmoidoscopy volvul","description":"Proctosigmoidoscopy, rigid; with decompression of volvulus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50620","name":"Removal of ureter stone","description":"Ureterolithotomy; middle one-third of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55520","name":"Removal of sperm cord lesion","description":"Excision of lesion of spermatic cord (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96156","name":"Hlth bhv assmt/reassessment","description":"Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95718","name":"Eeg phys/qhp 2-12 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2-12 hours of eeg recording; with video (veeg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20910","name":"Remove cartilage for graft","description":"Cartilage graft; costochondral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58956","name":"Bso omentectomy w/tah","description":"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64901","name":"Nerve graft add-on","description":"Nerve graft, each additional nerve; single strand (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36475","name":"Endovenous rf 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66600","name":"Remove iris and lesion","description":"Iridectomy, with corneoscleral or corneal section; for removal of lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75960","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64402","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70543","name":"Mri orbt/fac/nck w/o &w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15272","name":"Skin sub graft t/a/l add-on","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27596","name":"Amputation follow-up surgery","description":"Amputation, thigh, through femur, any level; re-amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57230","name":"Repair of urethral lesion","description":"Plastic repair of urethrocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21147","name":"Rcnstj mdfc lefort i 3/>grf","description":"Reconstruction midface, lefort i; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted bilateral alveolar cleft or multiple osteotomies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77316","name":"Brachytx isodose plan simple","description":"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31040","name":"Exploration behind upper jaw","description":"Pterygomaxillary fossa surgery, any approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67218","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2146.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"Nubhvl xm phys/qhp 1st hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22112","name":"Remove part thorax vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","name":"Anes px art fem art emblc","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery embolectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61880","name":"Revise/remove neuroelectrode","description":"Revision or removal of intracranial neurostimulator electrodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40650","name":"Rpr lip fth vermilion only","description":"Repair lip, full thickness; vermilion only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58340","name":"Catheter for hysterography","description":"Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (sis) or hysterosalpingography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95927","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0343","name":"Laparotomy islet cell transp","description":"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27496","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66180","name":"Aqueous shunt eye w/graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80100","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80415","name":"Tot estradiol response panel","description":"Chorionic gonadotropin stimulation panel; estradiol response this panel must include the following: estradiol, total (82670 x 2 on 3 pooled blood samples)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15401","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8265","name":"Haberman feeder","description":"Haberman feeder for cleft lip/palate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21602","name":"Exc ch wal tum w/o lymphadec","description":"Excision of chest wall tumor involving rib(s), with plastic reconstruction; without mediastinal lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1359.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68525","name":"Biopsy of tear sac","description":"Biopsy of lacrimal sac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77316","name":"Brachytx isodose plan simple","description":"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1255.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93621","name":"Comp ep evl l pac&rec c sins","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62362","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35560","name":"Art byp grft aortorenal","description":"Bypass graft, with vein; aortorenal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1506.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76000","name":"Fluoroscopy <1 hr phys/qhp","description":"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61642","name":"Dilat ic vspsm ea diff ter","description":"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54440","name":"Repair of penis","description":"Plastic operation of penis for injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108243.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0364","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27517","name":"Treat thigh fx growth plate","description":"Closed treatment of distal femoral epiphyseal separation; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64681","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38572","name":"Laparoscopy lymphadenectomy","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20703","name":"Rmvl imed rx delivery device","description":"Removal of drug-delivery device(s), intramedullary (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63621","name":"Srs spinal lesion addl","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25337","name":"Reconstruct ulna/radioulnar","description":"Reconstruction for stabilization of unstable distal ulna or distal radioulnar joint, secondary by soft tissue stabilization (eg, tendon transfer, tendon graft or weave, or tenodesis) with or without open reduction of distal radioulnar joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27477","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); tibia and fibula, proximal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521T","name":"Interrog dev eval wcs ip","description":"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522T","name":"Prgrmg dev eval wcs ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93297","name":"Rem interrog dev eval icpms","description":"Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors, analysis, review(s) and report(s) by a physician or other quali","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54200","name":"Injection px peyronie ds","description":"Injection procedure for peyronie disease;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"Per pm reeval est pat infant","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87335","name":"E coli 0157 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; escherichia coli 0157","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44127","name":"Enterectomy w/taper cong","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; with tapering","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2403.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37208","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46930","name":"Destroy internal hemorrhoids","description":"Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","name":"Anes opn/arthr px sho jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97760","name":"Orthotic mgmt&traing 1st enc","description":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75563","name":"Card mri w/stress img & dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78832","name":"Rp loclzj tum spect w/ct 2","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44188","name":"Lap colostomy","description":"Laparoscopy, surgical, colostomy or skin level cecostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86155","name":"Chemotaxis assay","description":"Chemotaxis assay, specify method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97032","name":"Appl modality 1+estim ea 15","description":"Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95870","name":"Ndl emg lmtd std musc 1 xtr","description":"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1266.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46707","name":"Repair anorectal fist w/plug","description":"Repair of anorectal fistula with plug (eg, porcine small intestine submucosa [sis])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29440","name":"Adding walker to prev cast","description":"Adding walker to previously applied cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26600","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; without manipulation, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82438","name":"Assay other fluid chlorides","description":"Chloride; other source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16020","name":"Dress/debrid p-thick burn s","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50920","name":"Closure ureter/skin fistula","description":"Closure of ureterocutaneous fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61616","name":"Resect/excise lesion skull","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or c1-c3 vertebral bodies; intradural, including dural repair, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2975.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82693","name":"Assay of ethylene glycol","description":"Ethylene glycol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36561","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33971","name":"Aortic circulation assist","description":"Removal of intra-aortic balloon assist device including repair of femoral artery, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2994.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84375","name":"Chromatogram assay sugars","description":"Sugars, chromatographic, tlc or paper chromatography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1562.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570T","name":"Ttvr perq ea addl prosth","description":"Transcatheter tricuspid valve repair, percutaneous approach; each additional prosthesis during same session (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74301","name":"X-rays at surgery add-on","description":"Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28309","name":"Incision of metatarsals","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; multiple (eg, swanson type cavus foot procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86005","name":"Allg spec ige multiallg scr","description":"Allergen specific ige; qualitative, multiallergen screen (eg, disk, sponge, card)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27468","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27498","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, multiple compartments;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33016","name":"Pericardiocentesis w/imaging","description":"Pericardiocentesis, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32603","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6025","name":"Silicone gel sheet, each","description":"Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49582","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78433","name":"Myocrd img pet 2rtracer ct","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2251.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43122","name":"Partial removal of esophagus","description":"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2131.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67210","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","KL","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33956","name":"Ecmo/ecls insj ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, 6 years and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75959","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97763","name":"Orthc/prostc mgmt sbsq enc","description":"Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61619","name":"Repair dura","description":"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneous flap (including galea, temporalis, frontalis or occipitalis muscle)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4495","name":"Thigh length surg stocking","description":"Surgical stockings thigh length, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27087","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91117","name":"Colon motility 6 hr study","description":"Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96902","name":"Mcrscp xm hair pluck/clipped","description":"Microscopic examination of hairs plucked or clipped by the examiner (excluding hair collected by the patient) to determine telogen and anagen counts, or structural hair shaft abnormality","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20926","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25320","name":"Repair/revise wrist joint","description":"Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulotomy and open reduction) for carpal instability","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0144","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27487","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1492.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99498","name":"Advncd care plan addl 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (list separately in addition to code for primary proce","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23107","name":"Arthrt glenhumrl jt w/expl","description":"Arthrotomy, glenohumeral joint, with joint exploration, with or without removal of loose or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21151","name":"Rcnstj mdfc lefrtii w/b1 grf","description":"Reconstruction midface, lefort ii; any direction, requiring bone grafts (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1479.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13151","name":"Cmplx rpr e/n/e/l 1.1-2.5 cm","description":"Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8105.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31652","name":"Bronch ebus samplng 1/2 node","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28825","name":"Partial amputation of toe","description":"Amputation, toe; interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40806","name":"Incision of lip fold","description":"Incision of labial frenum (frenotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12036","name":"Intmd rpr s/a/t/ext 20.1-30","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31614","name":"Tracheostoma revj complex","description":"Tracheostoma revision; complex, with flap rotation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36223","name":"Place cath carotid/inom art","description":"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27594","name":"Amputation follow-up surgery","description":"Amputation, thigh, through femur, any level; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29345","name":"Application of long leg cast","description":"Application of long leg cast (thigh to toes);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81518","name":"Onc brst mrna 11 genes","description":"Oncology (breast), mrna, gene expression profiling by real-time rt-pcr of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage risk for metastatic recurrence and likelihood of benefit from extended endocrine therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1936.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77412","name":"Radiation tx delivery lvl 3","description":"Radiation treatment delivery; level 3, multiple isocenters with photon therapy (eg, 2d, 3d, or imrt) or a single-isocenter photon therapy (eg, 3d or imrt) with active motion management, or total skin electrons, or mixed-electron/photon field(s), including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1742.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","KM","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36221","name":"Place cath thoracic aorta","description":"Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64653","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63706","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; larger than 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93655","name":"Icar cath abltj dscrt arrhyt","description":"Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrhythmia (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19295","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9484","name":"Remote e/m new pt 45mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6512","name":"Compres burn garment, noc","description":"Compression burn garment, not otherwise classified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73219","name":"Mri upper extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15838","name":"Exc excsv submental fat pad","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":89.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4918.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97167","name":"Ot eval high complex 60 min","description":"Occupational therapy evaluation, high complexity, requiring these components: an occupational profile and medical and therapy history, which includes review of medical and/or therapy records and extensive additional review of physical, cognitive, or psychosocial history related to current functional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6018","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33617","name":"Repair single ventricle","description":"Repair of complex cardiac anomalies (eg, single ventricle) by modified fontan procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1881.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15934","name":"Exc sacral pr ulc skn flap","description":"Excision, sacral pressure ulcer, with skin flap closure;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61708","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2341.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26037","name":"Decompress fingers/hand","description":"Decompressive fasciotomy, hand (excludes 26035)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96935","name":"Rcm img acquisj only ea addl","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition only, each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81120","name":"Idh1 common variants","description":"Idh1 (isocitrate dehydrogenase 1 [nadp+], soluble) (eg, glioma), common variants (eg, r132h, r132c)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28344","name":"Repair extra toe(s)","description":"Reconstruction, toe(s); polydactyly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81166","name":"Brca1 gene full dup/del alys","description":"Brca1 (brca1, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95808","name":"Polysom any age 1-3> param","description":"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10180","name":"I&d complex po wound infctj","description":"Incision and drainage, complex, postoperative wound infection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74178","name":"Ct abd&plv wo cntr flwd cntr","description":"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31572","name":"Largsc w/laser dstrj les","description":"Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50770","name":"Splicing of ureters","description":"Transureteroureterostomy, anastomosis of ureter to contralateral ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32853","name":"Lung transplant double","description":"Lung transplant, double (bilateral sequential or en bloc); without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3703.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0367","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11000","name":"Dbrdmt ecz/infected skin<10%","description":"Debridement of extensive eczematous or infected skin; up to 10% of body surface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17003","name":"Destruct premalg les 2-14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75774","name":"Artery x-ray each vessel","description":"Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36595","name":"Mech remov tunneled cv cath","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5693.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88174","name":"Cytopath c/v auto in fluid","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36571","name":"Insert picvad cath","description":"Insertion of peripherally inserted central venous access device, with subcutaneous port; age 5 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31638","name":"Bronchoscopy revise stent","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with revision of tracheal or bronchial stent inserted at previous session (includes tracheal/bronchial dilation as required)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45335","name":"Sigmoidoscopy w/submuc inj","description":"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40520","name":"Partial excision of lip","description":"Excision of lip; v-excision with primary direct linear closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33814","name":"Obltrj a-pulm sep def w/byp","description":"Obliteration of aortopulmonary septal defect, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1320.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80424","name":"Glucagon tolerance panel","description":"Glucagon tolerance panel; for pheochromocytoma this panel must include the following: catecholamines, fractionated (82384 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"Prev visit est age 1-4","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44401","name":"Colonoscopy with ablation","description":"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2175.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75573","name":"Ct hrt c+ strux cgen hrt ds","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3d image postprocessing, assessment of left ventricular [lv] cardiac function, right ventricular [rv] structure and function and evaluation of ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30400","name":"Reconstruction of nose","description":"Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47555","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with dilation of biliary duct stricture(s) without stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"Esrd svc pr day pt 12-19","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 12-19 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33953","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76881","name":"Us compl joint r-t w/img","description":"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7836.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29861","name":"Hip arthro w/fb removal","description":"Arthroscopy, hip, surgical; with removal of loose body or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27027","name":"Dcmprn fasct pel compartment","description":"Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9980","name":"Remote e/m new pt 30 mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed examination; medical decision making","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41806","name":"Removal foreign body jawbone","description":"Removal of embedded foreign body from dentoalveolar structures; bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10488.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11138.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15775","name":"Hair trnspl 1-15 punch grfts","description":"Punch graft for hair transplant; 1 to 15 punch grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52332","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, gibbons or double-j type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1124.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78800","name":"Rp loclzj tum 1 area 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54060","name":"Excision of penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69222","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23491","name":"Reinforce shoulder bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; proximal humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":859.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91303","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43855","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1420.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","name":"Tumor immunohistochem/manual","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88147","name":"Cytopath c/v automated","description":"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13152","name":"Cmplx rpr e/n/e/l 2.6-7.5 cm","description":"Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38209","name":"Wash harvest stem cells","description":"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing, per donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64470","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26479","name":"Shortening of hand tendon","description":"Shortening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22226","name":"Osteot dsc ant 1vrt sgm ea","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81177","name":"Atn1 gene detc abnor alleles","description":"Atn1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","name":"Anes spine manipulation","description":"Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1627.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11313","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43226","name":"Esoph endoscopy dilation","description":"Esophagoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) over guide wire","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73725","name":"Mr ang lwr ext w or w/o dye","description":"Magnetic resonance angiography, lower extremity, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98968","name":"Ph1 assmt&mgmt nqhp 21-30","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32660","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1852.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1833.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29893","name":"Endoscopic plantr fasciotomy","description":"Endoscopic plantar fasciotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67108","name":"Repair detached retina","description":"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3909.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82610","name":"Cystatin c","description":"Cystatin c","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2400.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95966","name":"Meg evoked single","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3260","name":"Ambulatory surgical boot eac","description":"Surgical boot/shoe, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26140","name":"Revise finger joint each","description":"Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41005","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4220","name":"Parenteral supply kit premix","description":"Parenteral nutrition supply kit; premix, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99281","name":"Emr dpt vst mayx req phy/qhp","description":"Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26426","name":"Repair finger/hand tendon","description":"Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); using local tissue(s), including lateral band(s), each finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86682","name":"Helminth antibody","description":"Antibody; helminth, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27448","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; without fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","name":"Anes xtrprt lwr abd prst8ect","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","name":"Anes hernia repair<1 yr age","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, younger than 1 year of age","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0437","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64910","name":"Nerve repair w/allograft","description":"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87107","name":"Fungi identification mold","description":"Culture, fungi, definitive identification, each organism; mold","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","name":"Anes vaginal px nos","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11641","name":"Exc f/e/e/n/l mal+mrg 0.6-1","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77326","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99281","name":"Emr dpt vst mayx req phy/qhp","description":"Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27435","name":"Incision of knee joint","description":"Capsulotomy, posterior capsular release, knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92286","name":"Ant sgm img i&r speclr mic","description":"Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93272","name":"Ecg/review interpret only","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76811","name":"Ob us detailed sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3370.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82980","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15300","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70470","name":"Ct head/brain w/o & w/dye","description":"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","name":"Anes hrna rpr<37wk brth<50","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2551.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0016","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94762","name":"N-invas ear/pls oximtry cont","description":"Noninvasive ear or pulse oximetry for oxygen saturation; by continuous overnight monitoring (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L0430","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88387","name":"Macroscopic xm dsj&prep tiss","description":"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86741","name":"Neisseria meningitidis","description":"Antibody; neisseria meningitidis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78816","name":"Pet image w/ct full body","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1228.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26045","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); open, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3651","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83663","name":"Fluoro polarize fetal lung","description":"Fetal lung maturity assessment; fluorescence polarization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93528","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45384","name":"Colonoscopy w/lesion removal","description":"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28011","name":"Incision of toe tendons","description":"Tenotomy, percutaneous, toe; multiple tendons","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25624","name":"Cltx carpl scphd fx w/mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54530","name":"Removal of testis","description":"Orchiectomy, radical, for tumor; inguinal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1358.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KM","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38305","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; extensive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","name":"Anes px art lower leg emblc","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"Prev visit new age 40-64","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24371","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral and ulnar component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1504.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50396","name":"Measure kidney pressure","description":"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68700","name":"Repair tear ducts","description":"Plastic repair of canaliculi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","name":"Tumor immunohistochem/manual","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61782","name":"Scan proc cranial extra","description":"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59851","name":"Induced abortion 1+njx d&c","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93745","name":"Set-up cardiovert-defibrill","description":"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ecg, transmission of data to data repository, patient instruction in wearing system and patient re","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2572.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43253","name":"Egd us transmural injxn/mark","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (eg, anesthetic, neurolytic agent) or fiducial marker(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duoden","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93012","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19302","name":"P-mastectomy w/ln removal","description":"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","name":"Anes px art lower leg nos","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3733.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72083","name":"X-ray exam entire spi 4/5 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63275","name":"Bx/exc xdrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1638.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92548","name":"Cdp-sot 6 cond w/i&r","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29875","name":"Arthrs knee surg synvct lmtd","description":"Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30600","name":"Repair mouth/nose fistula","description":"Repair fistula; oronasal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50300","name":"Remove cadaver donor kidney","description":"Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","name":"Anes maj lwr adb vsl ivc lig","description":"Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38572","name":"Laparoscopy lymphadenectomy","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34001","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; carotid, subclavian or innominate artery, by neck incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35535","name":"Art byp grft hepatorenal","description":"Bypass graft, with vein; hepatorenal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1684.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65400","name":"Removal of eye lesion","description":"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43195","name":"Esophagoscopy rigid balloon","description":"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56810","name":"Perineoplasty rpr per nonob","description":"Perineoplasty, repair of perineum, nonobstetrical (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25565","name":"Cltx rdl&uln shft fx w/mnpj","description":"Closed treatment of radial and ulnar shaft fractures; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88120","name":"Cytp urne 3-5 probes ea spec","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54830","name":"Remove epididymis lesion","description":"Excision of local lesion of epididymis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2187.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95872","name":"Ndl emg single fiber eltrd","description":"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32120","name":"Re-exploration of chest","description":"Thoracotomy; for postoperative complications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35570","name":"Art byp tibial-tib/peroneal","description":"Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90661","name":"Cciiv3 vac abx fr 0.5 ml im","description":"Influenza virus vaccine, trivalent (cciiv3), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27030","name":"Arthrotomy hip w/drainage","description":"Arthrotomy, hip, with drainage (eg, infection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69801","name":"Incise inner ear","description":"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23474","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1480.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75945","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27369","name":"Njx cntrst kne arthg/ct/mri","description":"Injection procedure for contrast knee arthrography or contrast enhanced ct/mri knee arthrography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13374.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","name":"Anes hrna rpr<37wk brth<50","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85345","name":"Coagulation time lee & white","description":"Coagulation time; lee and white","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28755","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74022","name":"Radex compl aqt abd series","description":"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12035","name":"Intmd rpr s/a/t/ext 12.6-20","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26770","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33985","name":"Ecmo/ecls rmvl ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5100.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97606","name":"Neg prs wnd ther dme>50 sqcm","description":"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (dme), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67901","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82784","name":"Assay iga/igd/igg/igm each","description":"Gammaglobulin (immunoglobulin); iga, igd, igg, igm, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76498","name":"Unlisted mr procedure","description":"Unlisted magnetic resonance procedure (eg, diagnostic, interventional)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P3001","name":"Screening pap smear by phys","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82045","name":"Albumin ischemia modified","description":"Albumin; ischemia modified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0129","name":"Php/iop ot service","description":"Occupational therapy services requiring the skills of a qualified occupational therapist, furnished as a component of a partial hospitalization or intensive outpatient treatment program, per session (45 minutes or more)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GO"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":8.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39545","name":"Revision of diaphragm","description":"Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61050","name":"Remove brain canal fluid","description":"Cisternal or lateral cervical (c1-c2) puncture; without injection (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2053.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29824","name":"Sho arthrs srg dstl claviclc","description":"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (mumford procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61750","name":"Incise skull/brain biopsy","description":"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1285.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27495","name":"Reinforce thigh","description":"Prophylactic treatment (nailing, pinning, plating, or wiring) with or without methylmethacrylate, femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63051","name":"C-laminoplasty w/graft/plate","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5394.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2186.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41114","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; with local tongue flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27726","name":"Repair fibula nonunion","description":"Repair of fibula nonunion and/or malunion with internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28261","name":"Revision of foot tendon","description":"Capsulotomy, midfoot; with tendon lengthening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4681.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75901","name":"Remove cva device obstruct","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21193","name":"Reconst lwr jaw w/o graft","description":"Reconstruction of mandibular rami, horizontal, vertical, c, or l osteotomy; without bone graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":993.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","name":"Anes 2&3 burn less 4 % tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; less than 4% total body surface area","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49905","name":"Omental flap intra-abdom","description":"Omental flap, intra-abdominal (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55876","name":"Place rt device/marker pros","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78430","name":"Myocrd img pet rst/strs w/ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36227","name":"Place cath xtrnl carotid","description":"Selective catheter placement, external carotid artery, unilateral, with angiography of the ipsilateral external carotid circulation and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3049.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27035","name":"Denervation of hip joint","description":"Denervation, hip joint, intrapelvic or extrapelvic intra-articular branches of sciatic, femoral, or obturator nerves","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90823","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74330","name":"X-ray bile/panc endoscopy","description":"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73221","name":"Mri joint upr extrem w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49505","name":"Prp i/hern init reduc >5 yr","description":"Repair initial inguinal hernia, age 5 years or older; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","name":"Anes opn rpr fx disrpj plvs","description":"Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33237","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; dual lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77402","name":"Radiation tx delivery lvl 1","description":"Radiation treatment delivery; level 1 (eg, single-electron field, multiple-electron fields, or 2d photons), including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55120","name":"Removal of scrotum lesion","description":"Removal of foreign body in scrotum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43205","name":"Esophagus endoscopy/ligation","description":"Esophagoscopy, flexible, transoral; with band ligation of esophageal varices","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61250","name":"Burr hole/treph sttl expl","description":"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92961","name":"Cardioversion electric int","description":"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26483","name":"Transplant/graft hand tendon","description":"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; with free tendon graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20957","name":"Mt bone graft microvasc","description":"Bone graft with microvascular anastomosis; metatarsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2337.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88167","name":"Cytopath tbs c/v select","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28450","name":"Tx tarsal b1 fx w/o mnpj ea","description":"Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19081","name":"Bx breast 1st lesion strtctc","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including stereotactic guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87143","name":"Culture typing glc/hplc","description":"Culture, typing; gas liquid chromatography (glc) or high pressure liquid chromatography (hplc) method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86171","name":"Complement fixation each","description":"Complement fixation tests, each antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0075T","name":"Perq stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67108","name":"Repair detached retina","description":"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0190","name":"Positioning cushion","description":"Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36247","name":"Ins cath abd/l-ext art 3rd","description":"Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36474","name":"Endovenous mchnchem add-on","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27409","name":"Repair of knee ligaments","description":"Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0442","name":"Annual alcohol screen 15 min","description":"Annual alcohol misuse screening, 5 to 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold); air and bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7168.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47371","name":"Laparo ablate liver cryosurg","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86609","name":"Bacterium antibody","description":"Antibody; bacterium, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33254","name":"Ablate atria lmtd","description":"Operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61332","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1790.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95872","name":"Ndl emg single fiber eltrd","description":"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23480","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31775","name":"Reconstruct bronchus","description":"Bronchoplasty; excision stenosis and anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43336","name":"Thorabd diaphr hern repair","description":"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; without implantation of mesh or other prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83902","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15958","name":"Exc trchntr pr ulc prep ostc","description":"Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77522","name":"Proton trmt simple w/comp","description":"Proton treatment delivery; simple, with compensation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82607","name":"Vitamin b-12","description":"Cyanocobalamin (vitamin b-12);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30125","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; complex, under bone or cartilage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69806","name":"Explore inner ear","description":"Endolymphatic sac operation; with shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3093.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25390","name":"Shorten radius or ulna","description":"Osteoplasty, radius or ulna; shortening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49572","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28737","name":"Revision of foot bones","description":"Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, miller type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37184","name":"Prim art m-thrmbc 1st vsl","description":"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9537","name":"Tc99m mebrofenin","description":"Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87253","name":"Virus inoculate tissue addl","description":"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43262","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with sphincterotomy/papillotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53505","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; penile","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84153","name":"Assay of psa total","description":"Prostate specific antigen (psa); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21501","name":"I&d dp absc/hmtma sft ts nck","description":"Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1895.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50825","name":"Construct bowel bladder","description":"Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (kock pouch or camey enterocystoplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441T","name":"Abltj perc lxtr/perph nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4419.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91035","name":"G-esoph reflx tst w/electrod","description":"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry ph electrode placement, recording, analysis and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2526.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97535","name":"Self care mngment training","description":"Self-care/home management training (eg, activities of daily living (adl) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":545.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67914","name":"Repair eyelid defect","description":"Repair of ectropion; suture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23500","name":"Cltx clavicular fx w/o mnpj","description":"Closed treatment of clavicular fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21725","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; with cast application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27259","name":"Treat hip dislocation","description":"Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc); with femoral shaft shortening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1312.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51525","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67110","name":"Repair detached retina","description":"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99173","name":"Visual acuity screen","description":"Screening test of visual acuity, quantitative, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1823.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","name":"Anes/analg cs dlvr neuraxial","description":"Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32607","name":"Thoracoscopy w/bx infiltrate","description":"Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43620","name":"Removal of stomach","description":"Gastrectomy, total; with esophagoenterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73550","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17264","name":"Dstrj mal les t/a/l 3.1-4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97112","name":"Neuromuscular reeducation","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4199","name":"Parenteral sol > 100gm prote","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52320","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77326","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21184","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 80 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2098.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44820","name":"Excision of mesentery lesion","description":"Excision of lesion of mesentery (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44377","name":"Small bowel endoscopy/biopsy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93572","name":"Iv dop vel&/press c flo ea","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88334","name":"Path consltj surg cyto xm ea","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0198T","name":"Ocular blood flow measure","description":"Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6967.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94350","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4532","name":"Ped size pull-on lg","description":"Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87350","name":"Hepatitis be ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis be antigen (hbeag)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86256","name":"Fluorescent antibody titer","description":"Fluorescent noninfectious agent antibody; titer, each antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93981","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63011","name":"Remove spine lamina 1/2 scrl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43333","name":"Transab esoph hiat hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","name":"Scr mammo bi incl cad","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90824","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63620","name":"Srs spinal lesion","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69990","name":"Microsurgery add-on","description":"Microsurgical techniques, requiring use of operating microscope (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97535","name":"Self care mngment training","description":"Self-care/home management training (eg, activities of daily living (adl) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","AU","AV","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24495","name":"Decompression fasct forearm","description":"Decompression fasciotomy, forearm, with brachial artery exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82544","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33990","name":"Insj perq vad l hrt arterial","description":"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, arterial access only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77012","name":"Ct scan for needle biopsy","description":"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76828","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21750","name":"Repair of sternum separation","description":"Closure of median sternotomy separation with or without debridement (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99188","name":"App topical fluoride varnish","description":"Application of topical fluoride varnish by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0316","name":"Prolong inpt eval add15 m","description":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25071","name":"Exc forearm les sc 3 cm/>","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82666","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93463","name":"Drug admin & hemodynmic meas","description":"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent administration, when performed (list separately in addition to","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58615","name":"Occlude fallopian tube(s)","description":"Occlusion of fallopian tube(s) by device (eg, band, clip, falope ring) vaginal or suprapubic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95024","name":"Iq tests w/allergenic xtrcs","description":"Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2187.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29075","name":"Appl cst elbw fngr short arm","description":"Application, cast; elbow to finger (short arm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33300","name":"Repair of heart wound","description":"Repair of cardiac wound; without bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35081","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1525.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61650","name":"Evasc prlng admn rx agnt 1st","description":"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial vascular territory","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96936","name":"Rcm i&r only ea addl lesion","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; interpretation and report only, each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22512","name":"Vertebroplasty addl inject","description":"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional cervicothoracic or lumbosacral vertebral body (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20550","name":"Njx 1 tendon sheath/ligament","description":"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49323","name":"Laparo drain lymphocele","description":"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63048","name":"Lam facetec &foramot ea addl","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional vertebral segment, cervical, thoracic, or lumbar (list separately in addition t","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33414","name":"Repair of aortic valve","description":"Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1870.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77334","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52352","name":"Cystouretero w/stone remove","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25073","name":"Exc forearm tum deep 3 cm/>","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92242","name":"Fluorescein&icg angiography","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0102","name":"Prostate ca screening; dre","description":"Prostate cancer screening; digital rectal examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95132","name":"Immntx 3 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 3 stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15956","name":"Exc trchntr pr ulc prep flap","description":"Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58240","name":"Removal of pelvis contents","description":"Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22842","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21050","name":"Removal of jaw joint","description":"Condylectomy, temporomandibular joint (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":701.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44146","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86711","name":"John cunningham antibody","description":"Antibody; jc (john cunningham) virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85611","name":"Prothrombin test","description":"Prothrombin time; substitution, plasma fractions, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29827","name":"Sho arthrs srg rt8tr cuf rpr","description":"Arthroscopy, shoulder, surgical; with rotator cuff repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63180","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35571","name":"Art byp pop-tibl-prl-other","description":"Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66940","name":"Extraction of lens","description":"Removal of lens material; extracapsular (other than 66840, 66850, 66852)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3588.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86376","name":"Microsomal antibody each","description":"Microsomal antibodies (eg, thyroid or liver-kidney), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77059","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92284","name":"Dx dark adaptation exam i&r","description":"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28122","name":"Partial removal of foot bone","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85247","name":"Clot factor viii multimetric","description":"Clotting; factor viii, von willebrand factor, multimetric analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62121","name":"Incise skull repair","description":"Craniotomy for repair of encephalocele, skull base","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1338.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1740.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88165","name":"Cytopath tbs c/v redo","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90808","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58340","name":"Catheter for hysterography","description":"Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (sis) or hysterosalpingography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82485","name":"Assay chondroitin sulfate","description":"Chondroitin b sulfate, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50660","name":"Removal of ureter","description":"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76942","name":"Echo guide for biopsy","description":"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61345","name":"Oth cranial dcmprn pst fossa","description":"Other cranial decompression, posterior fossa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1869.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93288","name":"Interrog evl pm/ldls pm ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system, or leadless pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34842","name":"Endovasc visc aorta 2 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98971","name":"Nqhp ol dig assmt&mgmt 11-20","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50972","name":"Ureter endoscopy & catheter","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4657","name":"Syringe w/wo needle","description":"Syringe, with or without needle, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33982","name":"Replace vad intra w/o bp","description":"Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1706.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4629.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":5642.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1529.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27178","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; closed manipulation with single or multiple pinning","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33236","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; single lead system, atrial or ventricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43360","name":"Gastrointestinal repair","description":"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with stomach, with or without pyloroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28666","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99170","name":"Anogenital exam child w imag","description":"Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37212","name":"Thrombolytic venous therapy","description":"Transcatheter therapy, venous infusion for thrombolysis, any method, including radiological supervision and interpretation, initial treatment day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0144T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49442","name":"Place cecostomy tube perc","description":"Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33222","name":"Relocation pocket pacemaker","description":"Relocation of skin pocket for pacemaker","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88121","name":"Cytp urine 3-5 probes cmptr","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4930","name":"Sterile, gloves per pair","description":"Gloves, sterile, per pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0252","name":"Pet imaging initial dx","description":"Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35456","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61630","name":"Balo angioplasty icr perq","description":"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83937","name":"Assay of osteocalcin","description":"Osteocalcin (bone g1a protein)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19328","name":"Rmvl intact breast implant","description":"Removal of intact breast implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64451","name":"Njx aa&/strd nrv nrvtg si jt","description":"Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87109","name":"Mycoplasma","description":"Culture, mycoplasma, any source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55605","name":"Vesiculotomy complicated","description":"Vesiculotomy; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83921","name":"Organic acid single quant","description":"Organic acid, single, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","name":"Anes lwr intst ndsc nos","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97810","name":"Acup 1/> wo estim 1st 15 min","description":"Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32098","name":"Open biopsy of lung pleura","description":"Thoracotomy, with biopsy(ies) of pleura","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23174","name":"Sqstrctmy humrl head srg nck","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to surgical neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88261","name":"Chromosome analysis 5","description":"Chromosome analysis; count 5 cells, 1 karyotype, with banding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24361","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with distal humeral prosthetic replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23397","name":"Muscle transfers","description":"Muscle transfer, any type, shoulder or upper arm; multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","name":"Anes px fcl b1/skl rad surg","description":"Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0249","name":"Provide inr test mater/equip","description":"Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82175","name":"Assay of arsenic","description":"Arsenic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47142","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; total right lobectomy (segments v, vi, vii and viii)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3968.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","name":"Anes opn/arthrs knee jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4606","name":"Oxygen probe used w oximeter","description":"Oxygen probe for use with oximeter device, replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24435","name":"Rpr non/mal hum with agrft","description":"Repair of nonunion or malunion, humerus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59866","name":"Abortion (mpr)","description":"Multifetal pregnancy reduction(s) (mpr)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4520","name":"Incontinence garment anytype","description":"Incontinence garment, any type, (e.g., brief, diaper), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2604.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32225","name":"Partial release of lung","description":"Decortication, pulmonary (separate procedure); partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95712","name":"Veeg 2-12 hr intmt mntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, 2-12 hours; with intermittent monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86320","name":"Serum immunoelectrophoresis","description":"Immunoelectrophoresis; serum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78433","name":"Myocrd img pet 2rtracer ct","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2170.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69635","name":"Repair eardrum structures","description":"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32656","name":"Thoracoscopy w/pleurectomy","description":"Thoracoscopy, surgical; with parietal pleurectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1553.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44370","name":"Small bowel endoscopy/stent","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11623","name":"Exc s/n/h/f/g mal+mrg 2.1-3","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32603","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22206","name":"Incis spine 3 column thorac","description":"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45136","name":"Excise ileoanal reservior","description":"Excision of ileoanal reservoir with ileostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1396.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46220","name":"Excise anal ext tag/papilla","description":"Excision of single external papilla or tag, anus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35261","name":"Rpr blvsl grf oth/thn vn nck","description":"Repair blood vessel with graft other than vein; neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74178","name":"Ct abd&plv wo cntr flwd cntr","description":"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61526","name":"Removal of brain lesion","description":"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2950.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6284.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45333","name":"Sigmoidoscopy & polypectomy","description":"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43882","name":"Rev/rmvl gstr nstim eltrd","description":"Revision or removal of gastric neurostimulator electrodes, antrum, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":519.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36582","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same venous access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2384.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","name":"Anes opn/arthr px sho jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80050","name":"General health panel","description":"General health panel this panel must include the following: comprehensive metabolic panel (80053) blood count, complete (cbc), automated and automated differential wbc count (85025 or 85027 and 85004) or blood count, complete (cbc), automated (85027) and appropriate manual differential wbc count (85","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00792","name":"Anes iper upr abd prtl hptc","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; partial hepatectomy or management of liver hemorrhage (excluding liver biopsy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86157","name":"Cold agglutinin titer","description":"Cold agglutinin; titer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67255","name":"Reinforce/graft eye wall","description":"Scleral reinforcement (separate procedure); with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92651","name":"Aep hearing status deter i&r","description":"Auditory evoked potentials; for hearing status determination, broadband stimuli, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24363","name":"Replace elbow joint","description":"Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54660","name":"Revision of testis","description":"Insertion of testicular prosthesis (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78429","name":"Myocrd img pet 1 std w/ct","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0314","name":"Counsel immune <21 16-30 m","description":"Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 16-30 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49451","name":"Replace duod/jej tube perc","description":"Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2723.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3107.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5012.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26416","name":"Graft hand or finger tendon","description":"Removal of synthetic rod and insertion of extensor tendon graft (includes obtaining graft), hand or finger, each rod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50957","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4323.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48146","name":"Pancreatectomy","description":"Pancreatectomy, distal, near-total with preservation of duodenum (child-type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9275","name":"Disp home glucose monitor","description":"Home glucose disposable monitor, includes test strips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56441","name":"Lysis of labial adhesions","description":"Lysis of labial adhesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96132","name":"Nrpsyc tst eval phys/qhp 1st","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the pati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95927","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11730","name":"Avulsion nail plate simple 1","description":"Avulsion of nail plate, partial or complete, simple; single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73522","name":"X-ray exam hips bi 3-4 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75658","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10010","name":"Fna bx w/ct gdn ea addl","description":"Fine needle aspiration biopsy, including ct guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94777","name":"Ped home apnea mntr rvw i&r","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; review, interpretation and preparation of report only by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19396","name":"Design custom breast implant","description":"Preparation of moulage for custom breast implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61601","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2158.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24152","name":"Rad resection tum radial h/n","description":"Radical resection of tumor, radial head or neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77421","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25274","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28202","name":"Repair/graft of foot tendon","description":"Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33241","name":"Remove pulse generator","description":"Removal of implantable defibrillator pulse generator only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93526","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1719.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50948","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96105","name":"Assessment of aphasia","description":"Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by boston diagnostic aphasia examination) with interpretation and report, per hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4057.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":5329.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47535","name":"Conversion ext bil drg cath","description":"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33800","name":"Aortic suspension","description":"Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31525","name":"Dx laryngoscopy excl nb","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83661","name":"L/s ratio fetal lung","description":"Fetal lung maturity assessment; lecithin sphingomyelin (l/s) ratio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0308","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33976","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1385.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90840","name":"Psytx crisis ea addl 30 min","description":"Psychotherapy for crisis; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64836","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; ulnar motor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43653","name":"Laparoscopy gastrostomy","description":"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27814","name":"Treatment of ankle fracture","description":"Open treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli), includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45389","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7534.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84449","name":"Assay of transcortin","description":"Transcortin (cortisol binding globulin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50120","name":"Pyelotomy w/exploration","description":"Pyelotomy; with exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9262.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35623","name":"Bpg axillary-pop/-tibial","description":"Bypass graft, with other than vein; axillary-popliteal or -tibial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27078","name":"Rsect hip tum incl femur","description":"Radical resection of tumor; ischial tuberosity and greater trochanter of femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37228","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92933","name":"Prq trlml c athrc st angiop1","description":"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54401","name":"Insert self-contd prosthesis","description":"Insertion of penile prosthesis; inflatable (self-contained)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42509","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with excision of both submandibular glands","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27686","name":"Revise lower leg tendons","description":"Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36576","name":"Repair tunneled cv cath","description":"Repair of central venous access device, with subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90870","name":"Electroconvulsive therapy","description":"Electroconvulsive therapy (includes necessary monitoring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11624","name":"Exc s/n/h/f/g mal+mrg 3.1-4","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","name":"Anes spine manipulation","description":"Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43201","name":"Esoph scope w/submucous inj","description":"Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54231","name":"Dynamic cavernosometry","description":"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88740","name":"Transcutaneous carboxyhb","description":"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80436","name":"Metyrapone panel","description":"Metyrapone panel this panel must include the following: cortisol (82533 x 2) 11 deoxycortisol (82634 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44008.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0102","name":"Prostate ca screening; dre","description":"Prostate cancer screening; digital rectal examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32551","name":"Insertion of chest tube","description":"Tube thoracostomy, includes connection to drainage system (eg, water seal), when performed, open (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93609","name":"Intra-vntr mapg tchycar site","description":"Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53430","name":"Reconstruction of urethra","description":"Urethroplasty, reconstruction of female urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63307","name":"Remov vert idrl bdy lmbr/sac","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2211.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11977","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73550","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93456","name":"R hrt coronary artery angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80410","name":"Calcitonin stimul panel","description":"Calcitonin stimulation panel (eg, calcium, pentagastrin) this panel must include the following: calcitonin (82308 x 3)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45332","name":"Sigmoidoscopy w/fb removal","description":"Sigmoidoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84260","name":"Assay of serotonin","description":"Serotonin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4045.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43635","name":"Removal of stomach partial","description":"Vagotomy when performed with partial distal gastrectomy (list separately in addition to code[s] for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24155","name":"Resection of elbow joint","description":"Resection of elbow joint (arthrectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25350","name":"Revision of radius","description":"Osteotomy, radius; distal third","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63688","name":"Rev/rmv imp sp npg/r dtch cn","description":"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27536","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); bicondylar, with or without internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27607","name":"Treat lower leg bone lesion","description":"Incision (eg, osteomyelitis or bone abscess), leg or ankle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15600","name":"Delay flap trunk","description":"Delay of flap or sectioning of flap (division and inset); at trunk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6025","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25316","name":"Revise palsy hand tendon(s)","description":"Flexor origin slide (eg, for cerebral palsy, volkmann contracture), forearm and/or wrist; with tendon(s) transfer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84085","name":"Assay of rbc pg6d enzyme","description":"Phosphogluconate, 6-, dehydrogenase, rbc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86940","name":"Hemolysins/agglutinins auto","description":"Hemolysins and agglutinins; auto, screen, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43865","name":"Revj gstr/jj anast w/vgtmy","description":"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85291","name":"Clot factor xiii fibrin scrn","description":"Clotting; factor xiii (fibrin stabilizing), screen solubility","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78272","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20220","name":"Bone biopsy trocar/ndl supfc","description":"Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33802","name":"Division aberrant vessel","description":"Division of aberrant vessel (vascular ring);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23700","name":"Mnpj anes sho jt fixj aprats","description":"Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43260","name":"Ercp w/specimen collection","description":"Endoscopic retrograde cholangiopancreatography (ercp); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35002","name":"Repair artery rupture neck","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, carotid, subclavian artery, by neck incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29355","name":"Appl long leg cast walker","description":"Application of long leg cast (thigh to toes); walker or ambulatory type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3674.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2018.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43259","name":"Egd us exam duodenum/jejunum","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27062","name":"Remove femur lesion/bursa","description":"Excision; trochanteric bursa or calcification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80156","name":"Assay carbamazepine total","description":"Carbamazepine; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30410","name":"Reconstruction of nose","description":"Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"Phlebotomy","description":"Phlebotomy, therapeutic (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75572","name":"Ct hrt w/3d image","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92519","name":"Vemp tst i&r cervical&ocular","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; cervical (cvemp) and ocular (ovemp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0313","name":"Immunize couns < 21yr 6-30 m","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52260","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50436","name":"Dilat xst trc ndurlgc px","description":"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4723","name":"Dialys sol fld vol > 2999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44188","name":"Lap colostomy","description":"Laparoscopy, surgical, colostomy or skin level cecostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4525","name":"Adult size pull-on sm","description":"Adult sized disposable incontinence product, protective underwear/pull-on, small size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58943","name":"Removal of ovary(s)","description":"Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments, with or without salpingectomy(s), with or without omentectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":20.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27619","name":"Exc leg/ankle tum deep <5 cm","description":"Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63086","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39501","name":"Repair diaphragm laceration","description":"Repair, laceration of diaphragm, any approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88177","name":"Cytp fna eval ea addl","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4725","name":"Dialys sol fld vol > 4999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27502","name":"Treatment of thigh fracture","description":"Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82634","name":"Deoxycortisol","description":"Deoxycortisol, 11-","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","name":"Anes px heart w/o pump oxtj","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33764","name":"Shunt central w/prostc graft","description":"Shunt; central, with prosthetic graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1140.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98960","name":"Edu&trn pt self-mgmt nqhp 1","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22869","name":"Insj stablj dev w/o dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85008","name":"Bl smear w/o diff wbc count","description":"Blood count; blood smear, microscopic examination without manual differential wbc count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22849","name":"Reinsert spinal fixation","description":"Reinsertion of spinal fixation device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77021","name":"Mri guidance ndl plmt rs&i","description":"Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78473","name":"Gated heart multiple","description":"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88155","name":"Cytopath c/v index add-on","description":"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (list separately in addition to code[s] for other technical and interpretation services)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44393","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21812","name":"Treatment of rib fracture","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 4-6 ribs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23525","name":"Cltx strnclav dislc w/mnpj","description":"Closed treatment of sternoclavicular dislocation; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25130","name":"Removal of wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45820","name":"Repair rectourethral fistula","description":"Closure of rectourethral fistula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6491.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92532","name":"Positional nystagmus test","description":"Positional nystagmus test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77435","name":"Sbrt management","description":"Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4927","name":"Non-sterile gloves","description":"Gloves, non-sterile, per 100","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31201","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27147","name":"Revision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone; with open reduction of hip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1243.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81189","name":"Cstb gene full gene sequence","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; full gene sequence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1750.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92354","name":"Fitg spect low vis 1system","description":"Fitting of spectacle mounted low vision aid; single element system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65765","name":"Keratophakia","description":"Keratophakia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52277","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with resection of external sphincter (sphincterotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80400","name":"Acth stimulation panel","description":"Acth stimulation panel; for adrenal insufficiency this panel must include the following: cortisol (82533 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78496","name":"Heart first pass add-on","description":"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99485","name":"Suprv interfacilty transport","description":"Supervision by a control physician of interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with transport team before transport, at the referring facility and during the transport, including data inter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26686","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; complex, multiple, or delayed reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60545","name":"Explore adrenal gland","description":"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49418","name":"Insert tun ip cath perc","description":"Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, contrast injection when performed, and radiological supervision and interpretation, percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22512","name":"Vertebroplasty addl inject","description":"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional cervicothoracic or lumbosacral vertebral body (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4252","name":"Blood ketone test or strip","description":"Blood ketone test or reagent strip, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84030","name":"Assay of blood pku","description":"Phenylalanine (pku), blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92284","name":"Dx dark adaptation exam i&r","description":"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64795","name":"Biopsy of nerve","description":"Biopsy of nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25535","name":"Cltx ulnar shft fx w/mnpj","description":"Closed treatment of ulnar shaft fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78814","name":"Pet image w/ct lmtd","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33468","name":"Revision of tricuspid valve","description":"Tricuspid valve repositioning and plication for ebstein anomaly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2136.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38382","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42955","name":"Surgical opening of throat","description":"Pharyngostomy (fistulization of pharynx, external for feeding)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19296","name":"Place po breast cath for rad","description":"Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; on date separate from partial mastectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0080","name":"Care manag h vst new pt 75 m","description":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36470","name":"Njx sclrsnt 1 incmptnt vein","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1384.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87400","name":"Influenza a/b each ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; influenza, a or b, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61751","name":"Brain biopsy w/ct/mr guide","description":"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44625","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63276","name":"Bx/exc xdrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1623.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","KL","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94640","name":"Airway inhalation treatment","description":"Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (ippb) device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38230","name":"Bone marrow harvest allogen","description":"Bone marrow harvesting for transplantation; allogeneic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90808","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33244","name":"Remove elctrd transvenously","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78496","name":"Heart first pass add-on","description":"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91065","name":"Breath hydrogen/methane test","description":"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0326","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92506","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69105","name":"Biopsy of external ear canal","description":"Biopsy external auditory canal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99223","name":"1st hosp ip/obs high 75","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26261","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2187.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19030","name":"Njx px only mam ducto/glcto","description":"Injection procedure only for mammary ductogram or galactogram","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21497","name":"Interdental wirg oth/thn fx","description":"Interdental wiring, for condition other than fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":625.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0179","name":"Md recertification hha pt","description":"Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","name":"Anes px art knee&pop teaec","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93582","name":"Perq transcath closure pda","description":"Percutaneous transcatheter closure of patent ductus arteriosus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3942.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94350","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46608","name":"Anoscopy remove for body","description":"Anoscopy; with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61698","name":"Brain aneurysm repr complx","description":"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4505.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92585","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01850","name":"Anes vein f/arm wrst&hnd nos","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27556","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; without primary ligamentous repair or augmentation/reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85044","name":"Manual reticulocyte count","description":"Blood count; reticulocyte, manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51820","name":"Revision of urinary tract","description":"Cystourethroplasty with unilateral or bilateral ureteroneocystostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37600","name":"Ligation xtrnl carotid art","description":"Ligation; external carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0079","name":"Care manag h vst new pt 60 m","description":"Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57530","name":"Removal of cervix","description":"Trachelectomy (cervicectomy), amputation of cervix (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","name":"Anes arthr/ndsc wrst/hnd nos","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54385","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter; with incontinence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82955","name":"Assay of g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68500","name":"Removal of tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0366","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34707","name":"Evasc rpr ilio-iliac ndgft","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1016.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4081.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","name":"Anes all px neck nos 1yr/>","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75680","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39540","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; acute","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80415","name":"Tot estradiol response panel","description":"Chorionic gonadotropin stimulation panel; estradiol response this panel must include the following: estradiol, total (82670 x 2 on 3 pooled blood samples)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91038","name":"Esoph imped funct test > 1hr","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94776","name":"Ped home apnea mntr dl&alys","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; monitoring, download of information, receipt of transmission(s) and analyses by computer only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29826","name":"Sho arthrs srg decompression","description":"Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) release, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":115.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78709","name":"K flow/funct image multiple","description":"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93459","name":"L hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter place","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":90.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3911","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","name":"Anes ivntl rad artl crtd/c","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86225","name":"Dna antibody native","description":"Deoxyribonucleic acid (dna) antibody; native or double stranded","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93923","name":"Upr/lxtr art stdy 3+ lvls","description":"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional doppler wave","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58200","name":"Extensive hysterectomy","description":"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47125","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total left lobectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2580.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77055","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32852","name":"Lung transplant with bypass","description":"Lung transplant, single; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2859.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98966","name":"Ph1 assmt&mgmt nqhp 5-10","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63304","name":"Remove vert idrl body crvcl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49606","name":"Repair umbilical lesion","description":"Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":952.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45339","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42415","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54670","name":"Repair testis injury","description":"Suture or repair of testicular injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10737.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47780","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":19.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64818","name":"Sympathectomy lumbar","description":"Sympathectomy, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70558","name":"Mri brain w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75996","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36584","name":"Compl rplcmt picc rs&i","description":"Replacement, complete, of a peripherally inserted central venous catheter (picc), without subcutaneous port or pump, through same venous access, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78830","name":"Rp loclzj tum spect w/ct 1","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28003","name":"Treatment of foot infection","description":"Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92002","name":"Intrm oph exam new patient","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33471","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1148.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27418","name":"Repair degenerated kneecap","description":"Anterior tibial tubercleplasty (eg, maquet type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93652","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","BA","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32665","name":"Thoracoscop w/esoph musc exc","description":"Thoracoscopy, surgical; with esophagomyotomy (heller type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94760","name":"N-invas ear/pls oximetry 1","description":"Noninvasive ear or pulse oximetry for oxygen saturation; single determination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50555","name":"Kidney endoscopy & biopsy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99339","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11960","name":"Insert tissue expander(s)","description":"Insertion of tissue expander(s) for other than breast, including subsequent expansion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35616","name":"Bpg subclavian-axillary","description":"Bypass graft, with other than vein; subclavian-axillary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0250","name":"Md inr test revie inter mgmt","description":"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of servic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20501","name":"Njx sinus tract diagnostic","description":"Injection of sinus tract; diagnostic (sinogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":348.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64553","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; cranial nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","name":"Anes px heart w/pmp crc arst","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3311.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":518.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47532","name":"Injection for cholangiogram","description":"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36907","name":"Balo angiop ctr dialysis seg","description":"Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplasty (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90962","name":"Esrd serv 1 visit p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 1 face-to-face visit by a physician or other qualified health care professional per month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97597","name":"Dbrdmt opn wnd 1st 20 cm/<","description":"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when perform","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","name":"Anes dx/ther nrv blk&inj prn","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3942.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90876","name":"Psychophysiological therapy","description":"Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 45 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22521","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":252.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63251","name":"Revise spinal cord vsls thrc","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2801.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15175","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39545","name":"Revision of diaphragm","description":"Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33702","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1341.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44404","name":"Colonoscopy w/injection","description":"Colonoscopy through stoma; with directed submucosal injection(s), any substance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75635","name":"Ct angio abdominal arteries","description":"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77772","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28715.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","name":"Anes all px nrv msc kne&/pop","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93566","name":"Njx car cth slctv rv/ra ang","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2384.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20956","name":"Iliac bone graft microvasc","description":"Bone graft with microvascular anastomosis; iliac crest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2246.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27562","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93231","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27228","name":"Treat hip fracture(s)","description":"Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes t-fracture and both column fracture with complete articular detachment, or single column or transverse fracture with associated acetabular wall fracture, with internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1594.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36825","name":"Artery-vein autograft","description":"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77001","name":"Fluoroguide for vein device","description":"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic su","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26370","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99309","name":"Sbsq nf care moderate mdm 30","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64761","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15829","name":"Rhytidectomy smas flap","description":"Rhytidectomy; superficial musculoaponeurotic system (smas) flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93797","name":"Phys/qhp op car rhab wo ecg","description":"Physician or other qualified health care professional services for outpatient cardiac rehabilitation; without continuous ecg monitoring (per session)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91055","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","name":"Anes px art knee&pop teaec","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58974","name":"Embryo transfer intrauterine","description":"Embryo transfer, intrauterine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22222","name":"Osteot dsc ant 1vrt sgm thrc","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1581.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77772","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82128","name":"Amino acids mult qual","description":"Amino acids; multiple, qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43107","name":"Removal of esophagus","description":"Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2482.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52400","name":"Cysto cgen post urtl valves","description":"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77059","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66250","name":"Follow-up surgery of eye","description":"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43860","name":"Revj gstr/jj anast w/o vgtmy","description":"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; without vagotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1364.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44378","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93656","name":"Compre ep eval abltj atr fib","description":"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including left or right atrial pacing/recording, and intracardiac catheter ablation of atrial fibrillation by ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1199.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84490","name":"Assay of feces for trypsin","description":"Trypsin; feces, quantitative, 24-hour collection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19371","name":"Peri-implt capslc brst compl","description":"Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50920","name":"Closure ureter/skin fistula","description":"Closure of ureterocutaneous fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4818.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69554","name":"Exc aurl glomus tum extended","description":"Excision aural glomus tumor; extended (extratemporal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2034.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99469","name":"Neonate crit care subsq","description":"Subsequent inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38550","name":"Removal neck/armpit lesion","description":"Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29893","name":"Endoscopic plantr fasciotomy","description":"Endoscopic plantar fasciotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3419.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":6491.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70373","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61635","name":"Intracran angioplsty w/stent","description":"Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1263.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31531","name":"Laryngoscopy w/fb & op scope","description":"Laryngoscopy, direct, operative, with foreign body removal; with operating microscope or telescope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76706","name":"Us abdl aorta screen aaa","description":"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (aaa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33822","name":"Repair pda div<18 years","description":"Repair of patent ductus arteriosus; by division, younger than 18 years","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15130","name":"Drm agrft t/a/l 1st 100 sqcm","description":"Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83631","name":"Lactoferrin fecal (quant)","description":"Lactoferrin, fecal; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":713.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1389.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99288","name":"Direct advanced life support","description":"Physician or other qualified health care professional direction of emergency medical systems (ems) emergency care, advanced life support","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60252","name":"Removal of thyroid","description":"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1116.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77316","name":"Brachytx isodose plan simple","description":"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47525","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27217","name":"Treat pelvic ring fracture","description":"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes pubic symphysis and/or ipsilateral superior/inferior rami)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33889","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","name":"Anes cardiac catheterization","description":"Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include swan-ganz catheter)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28515","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47120","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; partial lobectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85280","name":"Clot factor xii hageman","description":"Clotting; factor xii (hageman)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","name":"Anes xtnsv sp&spi cord px","description":"Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47612","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with choledochoenterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88143","name":"Cytopath c/v thin layer redo","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33321","name":"Repair major vessel","description":"Suture repair of aorta or great vessels; with shunt bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1027.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0431","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27690","name":"Revise lower leg tendon","description":"Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial (eg, anterior tibial extensors into midfoot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0509","name":"Crit care telehea consult 50","description":"Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78414","name":"Non-imaging heart function","description":"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46288","name":"Repair anal fistula","description":"Closure of anal fistula with rectal advancement flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22869","name":"Insj stablj dev w/o dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28092","name":"Removal of toe lesions","description":"Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); toe(s), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33502","name":"Coronary artery correction","description":"Repair of anomalous coronary artery from pulmonary artery origin; by ligation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93318","name":"Echo transesophageal intraop","description":"Echocardiography, transesophageal (tee) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17000","name":"Destruct premalg lesion","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87510","name":"Gardner vag dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1768","name":"Graft, vascular","description":"Graft, vascular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84181","name":"Western blot test","description":"Protein; western blot, with interpretation and report, blood or other body fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23802","name":"Arthrd glenohumeral jt w/grf","description":"Arthrodesis, glenohumeral joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74178","name":"Ct abd&plv wo cntr flwd cntr","description":"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86663","name":"Epstein-barr antibody","description":"Antibody; epstein-barr (eb) virus, early antigen (ea)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70373","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43247","name":"Egd remove foreign body","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57110","name":"Vagnc compl rmvl vag wall","description":"Vaginectomy, complete removal of vaginal wall;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3076.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0503","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","name":"Emergency dept visit mod mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403T","name":"Diabetes prev standard curr","description":"Preventive behavior change, intensive program of prevention of diabetes using a standardized diabetes prevention program curriculum, provided to individuals in a group setting, minimum 60 minutes, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A7043","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33534","name":"Cabg arterial two","description":"Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8902","name":"Mra w/o fol w/cont, abd","description":"Magnetic resonance angiography without contrast followed by with contrast, abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50546","name":"Laparoscopic nephrectomy","description":"Laparoscopy, surgical; nephrectomy, including partial ureterectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59409","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95721","name":"Eeg phy/qhp>36<60 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 36 hours, up to 60 hours of eeg recording, without video","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43266","name":"Egd endoscopic stent place","description":"Esophagogastroduodenoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61315","name":"Crnec/crnot ittl ntracereblr","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1890.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15933","name":"Exc sac pr ulc prim str ostc","description":"Excision, sacral pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33231","name":"Insrt pulse gen w/mult leads","description":"Insertion of implantable defibrillator pulse generator only; with existing multiple leads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64561","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54300","name":"Revision of penis","description":"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99471","name":"Ped critical care initial","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77012","name":"Ct scan for needle biopsy","description":"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21445","name":"Optx mndblr/max alv ridge fx","description":"Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55880","name":"Abltj mal prst8 tiss hifu","description":"Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23155","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87471","name":"Bartonella dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); bartonella henselae and bartonella quintana, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40652","name":"Rpr lip fth<half ver height","description":"Repair lip, full thickness; up to half vertical height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86759","name":"Rotavirus antibody","description":"Antibody; rotavirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80102","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85379","name":"Fibrin degradation quant","description":"Fibrin degradation products, d-dimer; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33507","name":"Repair art intramural","description":"Repair of anomalous (eg, intramural) aortic origin of coronary artery by unroofing or translocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1498.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63266","name":"Excise intrspinl lesion thrc","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1558.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82009","name":"Ketone bodys qual","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3503.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19285","name":"Perq dev breast 1st us imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":22.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21267","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92937","name":"Prq trluml revsc cab grf 1","description":"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed, single major coronary artery and/or its branches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","name":"Anes 2&3 burn 4-9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; between 4% and 9% of total body surface area","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2606.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88307","name":"Tissue exam by pathologist","description":"Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"Family psytx w/pt 50 min","description":"Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61323","name":"Crnec/crnot dcmprv w/lobec","description":"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2202.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78708","name":"K flow/funct image w/drug","description":"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85421","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93985","name":"Dup-scan hemo compl bi std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15275","name":"Skin sub graft face/nk/hf/g","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83883","name":"Assay nephelometry not spec","description":"Nephelometry, each analyte not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36560","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; younger than 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88304","name":"Tissue exam by pathologist","description":"Level iii - surgical pathology, gross and microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque bartholins gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel t","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71035","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24359","name":"Repair elbow deb/attch open","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); debridement, soft tissue and/or bone, open with tendon repair or reattachment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85555","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; unincubated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5067.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","name":"Anes open/arthr ntrthrc amp","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; interthoracoscapular (forequarter) amputation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37605","name":"Ligation int/com carotid art","description":"Ligation; internal or common carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70557","name":"Mri brain w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87190","name":"Sc std myobacteria prop meth","description":"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50236","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through separate incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1185.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23221","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43501","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of bleeding ulcer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1125.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66986","name":"Exchange lens prosthesis","description":"Exchange of intraocular lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99306","name":"1st nf care high mdm 50","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes must be met or exceed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27161","name":"Incision of neck of femur","description":"Osteotomy, femoral neck (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69670","name":"Remove mastoid air cells","description":"Mastoid obliteration (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33611","name":"Repair double ventricle","description":"Repair of double outlet right ventricle with intraventricular tunnel repair;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1698.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","name":"Neuraxl lbr anes vag dlvr","description":"Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6019","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0054T","name":"Bone srgry cmptr fluor image","description":"Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14061","name":"Tis trnfr e/n/e/l10.1-30sqcm","description":"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82387","name":"Assay of cathepsin-d","description":"Cathepsin-d","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73720","name":"Mri lwr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44160","name":"Removal of colon","description":"Colectomy, partial, with removal of terminal ileum with ileocolostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1027.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32557","name":"Insert cath pleura w/ image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61020","name":"Remove brain cavity fluid","description":"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4088","name":"Gastro/jejuno tube, low-pro","description":"Gastrostomy/jejunostomy tube, low-profile, any material, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82979","name":"Assay rbc glutathione","description":"Glutathione reductase, rbc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99254","name":"Ip/obs cnsltj new/est mod 60","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":10238.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9157","name":"Transesoph doppl cardiac mon","description":"Transesophageal doppler measurement of cardiac output (including probe placement, image acquisition, and interpretation per course of treatment) for monitoring purposes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11620","name":"Exc h-f-nk-sp mal+marg 0.5/<","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75685","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11005","name":"Dbrdmt skin abdominal wall","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; abdominal wall, with or without fascial closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45020","name":"Drainage of rectal abscess","description":"Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76706","name":"Us abdl aorta screen aaa","description":"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (aaa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63016","name":"Remove spine lamina >2 thrc","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1367.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36147","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67141","name":"Proph rta dtchmnt crtx dthrm","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89325","name":"Sperm antibody test","description":"Sperm antibodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1951.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","KM","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00942","name":"Anes vag px clptmy vgnc clpr","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); colpotomy, vaginectomy, colporrhaphy, and open urethral procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1892.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96932","name":"Rcm img acquisj only 1st les","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition only, first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48140","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1649.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","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, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1907.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87269","name":"Giardia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; giardia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35548","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"UNK","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":69.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28340","name":"Resect enlarged toe tissue","description":"Reconstruction, toe, macrodactyly; soft tissue resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76942","name":"Echo guide for biopsy","description":"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21243","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with prosthetic joint replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1309.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49000","name":"Exploration of abdomen","description":"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24136","name":"Sequestrectomy radial h/n","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), radial head or neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66172","name":"Incision of eye","description":"Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":859.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66630","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86905","name":"Blood typing rbc antigens","description":"Blood typing, serologic; rbc antigens, other than abo or rh (d), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77334","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2975.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69505","name":"Remove mastoid structures","description":"Mastoidectomy; modified radical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25609","name":"Optx dst rd xart fx/ep sep3+","description":"Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62370","name":"Anl sp inf pmp w/mdreprg&fil","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill (requiring skill of a physician or other qualified health care professional)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33233","name":"Removal of pm generator","description":"Removal of permanent pacemaker pulse generator only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"Spirmtry w/brnchdil inf-2 yr","description":"Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74251","name":"X-ray xm sm int 2cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","name":"Anes px hrt w/pump age 1yr+","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21196","name":"Reconst lwr jaw w/fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43453","name":"Dilate esophagus","description":"Dilation of esophagus, over guide wire","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88153","name":"Cytopath c/v redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88334","name":"Path consltj surg cyto xm ea","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85303","name":"Clot inhibit prot c activity","description":"Clotting inhibitors or anticoagulants; protein c, activity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86790","name":"Virus antibody nos","description":"Antibody; virus, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99236","name":"Hosp ip/obs same date hi 85","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter f","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59525","name":"Remove uterus after cesarean","description":"Subtotal or total hysterectomy after cesarean delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27240","name":"Treat thigh fracture","description":"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74283","name":"Ther nma rdctj intus/obstrcj","description":"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76376","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35211","name":"Rpr blvsl dir ntrathrc w/byp","description":"Repair blood vessel, direct; intrathoracic, with bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","name":"Anes dx/ther nrv blk&inj oth","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31080","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86817","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, multiple antigens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77772","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11740","name":"Evacuation subungual hmtma","description":"Evacuation of subungual hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31237","name":"Nsl/sins ndsc surg bx polypc","description":"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12057","name":"Intmd rpr face/mm >30.0 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49205","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92621","name":"Auditory function + 15 min","description":"Evaluation of central auditory function, with report; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71035","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88313","name":"Special stains group 2","description":"Special stain including interpretation and report; group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24071","name":"Exc arm/elbow les sc 3 cm/>","description":"Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32701","name":"Thorax stereo rad targetw/tx","description":"Thoracic target(s) delineation for stereotactic body radiation therapy (srs/sbrt), (photon or particle beam), entire course of treatment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27146","name":"Incision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41874","name":"Alveoloplasty each quadrant","description":"Alveoloplasty, each quadrant (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28024","name":"Exploration of toe joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57267","name":"Insert mesh/pelvic flr addon","description":"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55801","name":"Removal of prostate","description":"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44605","name":"Repair of bowel lesion","description":"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82705","name":"Fats/lipids feces qual","description":"Fat or lipids, feces; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75774","name":"Artery x-ray each vessel","description":"Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1359.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24577","name":"Cltx humrl cndylr fx w/mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","name":"Anes px art knee&pop nos","description":"Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4153","name":"Ef hydrolyzed/amino acids","description":"Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7272","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25671","name":"Perq skel fix rad/uln dislc","description":"Percutaneous skeletal fixation of distal radioulnar dislocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33519","name":"Cabg artery-vein three","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 3 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97610","name":"Low frequency non-thermal us","description":"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83060","name":"Hgb sulfhemoglobin quan","description":"Hemoglobin; sulfhemoglobin, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24000","name":"Arthrt elbw expl drg/rmvl fb","description":"Arthrotomy, elbow, including exploration, drainage, or removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01820","name":"Anes clsd px rds u/w/h bones","description":"Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43763","name":"Rplc gtube revj gstrst trc","description":"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; requiring revision of gastrostomy tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74174","name":"Cta abd&plvs w/contrast","description":"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00860","name":"Anes xtrprtl px lwr abd nos","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82205","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33140","name":"Heart revascularize (tmr)","description":"Transmyocardial laser revascularization, by thoracotomy; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2252","name":"Brief chkin by md/qhp, 11-20","description":"Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor le","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16384.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26340","name":"Manipulate finger w/anesth","description":"Manipulation, finger joint, under anesthesia, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85130","name":"Chromogenic substrate assay","description":"Chromogenic substrate assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87905","name":"Ia nzmtc actv oth/thn virus","description":"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35565","name":"Art byp grft iliofemoral","description":"Bypass graft, with vein; iliofemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23455","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; with labral repair (eg, bankart procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3257.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27823","name":"Treatment of ankle fracture","description":"Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; with fixation of posterior lip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4046.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5454.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0440","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43648","name":"Lap revise/remv eltrd antrum","description":"Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12015","name":"Rpr f/e/e/n/l/m 7.6-12.5 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28035","name":"Decompression of tibia nerve","description":"Release, tarsal tunnel (posterior tibial nerve decompression)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19355","name":"Correct inverted nipple(s)","description":"Correction of inverted nipples","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","name":"Anes arthr/ndsc tot wrst rpl","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37187","name":"Venous mech thrombectomy","description":"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34826","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94770","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25676","name":"Optx rad/uln dislc aqt/chrnc","description":"Open treatment of distal radioulnar dislocation, acute or chronic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27232","name":"Treat thigh fracture","description":"Closed treatment of femoral fracture, proximal end, neck; with manipulation, with or without skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67430","name":"Explore/treat eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83919","name":"Organic acids qual each","description":"Organic acids; qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42335","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), complicated, intraoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72081","name":"X-ray exam entire spi 1 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15221","name":"Fth/gft fr s/a/l each addl","description":"Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43247","name":"Egd remove foreign body","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","name":"Anes px vn lwr leg ven thrmb","description":"Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25444","name":"Arthrp w/prostc lunate","description":"Arthroplasty with prosthetic replacement; lunate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63020","name":"Lamot dcmprn nrv rt 1 cerv","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1027.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28130","name":"Removal of ankle bone","description":"Talectomy (astragalectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2995.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64636","name":"Destroy l/s facet jnt addl","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); lumbar or sacral, each additional facet joint (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0341","name":"Percutaneous islet celltrans","description":"Percutaneous islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27372","name":"Removal of foreign body","description":"Removal of foreign body, deep, thigh region or knee area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53449","name":"Repair uro sphincter","description":"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1584.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90749","name":"Unlisted vaccine/toxoid","description":"Unlisted vaccine/toxoid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61552","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; multiple cranial sutures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3656.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91055","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50706","name":"Balloon dilate urtrl strix","description":"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1586.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58674","name":"Laps abltj uterine fibroids","description":"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55873","name":"Cryoablate prostate","description":"Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38780","name":"Remove abdomen lymph nodes","description":"Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50820","name":"Construct bowel bladder","description":"Ureteroileal conduit (ileal bladder), including intestine anastomosis (bricker operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1067.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1751.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88172","name":"Cytp dx eval fna 1st ea site","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64902","name":"Nerve graft add-on","description":"Nerve graft, each additional nerve; multiple strands (cable) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4813.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27715","name":"Ostpl tibfib lngth/shrt","description":"Osteoplasty, tibia and fibula, lengthening or shortening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49020","name":"Drainage abdom abscess open","description":"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1319.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86612","name":"Blastomyces antibody","description":"Antibody; blastomyces","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39502","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29126","name":"Appl short arm splint dyn","description":"Application of short arm splint (forearm to hand); dynamic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11420","name":"Exc h-f-nk-sp b9+marg 0.5/<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67908","name":"Repair eyelid defect","description":"Repair of blepharoptosis; conjunctivo-tarso-mullers muscle-levator resection (eg, fasanella-servat type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66711","name":"Ecp ciliary body destruction","description":"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36460","name":"Intrauterine transfusion ftl","description":"Transfusion, intrauterine, fetal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93540","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49905","name":"Omental flap intra-abdom","description":"Omental flap, intra-abdominal (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33600","name":"Closure of valve","description":"Closure of atrioventricular valve (mitral or tricuspid) by suture or patch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0430","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35565","name":"Art byp grft iliofemoral","description":"Bypass graft, with vein; iliofemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95966","name":"Meg evoked single","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58953","name":"Tah rad dissect for debulk","description":"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1275.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49610","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); first stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36556","name":"Insert non-tunnel cv cath","description":"Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4541","name":"Large disposable underpad","description":"Incontinence product, disposable underpad, large, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66821","name":"After cataract laser surgery","description":"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, yag laser) (1 or more stages)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77767","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30430","name":"Revision of nose","description":"Rhinoplasty, secondary; minor revision (small amount of nasal tip work)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","RR","TC","MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35371","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; common femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27477","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); tibia and fibula, proximal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63045","name":"Lam facetec & foramot crv","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0009","name":"Admin pneumococcal vaccine","description":"Administration of pneumococcal vaccine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0209T","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold), automated; air and bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27712","name":"Osteot mlt relignmt imed rod","description":"Osteotomy; multiple, with realignment on intramedullary rod (eg, sofield type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15851","name":"Removal sutr/staple req anes","description":"Removal of sutures or staples requiring anesthesia (ie, general anesthesia, moderate sedation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78227","name":"Hepatobil syst image w/drug","description":"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49557","name":"Rerepair fem hernia blocked","description":"Repair recurrent femoral hernia; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4539","name":"Reuse diaper/brief any size","description":"Incontinence product, diaper/brief, reusable, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43326","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":988.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64475","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61345","name":"Oth cranial dcmprn pst fossa","description":"Other cranial decompression, posterior fossa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1869.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13827.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10060","name":"I&d abscess simple/single","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76886","name":"Us exam infant hips static","description":"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38243","name":"Transplj hematopoietic boost","description":"Hematopoietic progenitor cell (hpc); hpc boost","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50620","name":"Removal of ureter stone","description":"Ureterolithotomy; middle one-third of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","name":"Anes all px nck ndl bx thyr","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0397","name":"Alcohol/subs interv >30 min","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5536.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92004","name":"Compre oph exam new pt 1/>","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64487","name":"Tap block uni by infusion","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0426","name":"Inpt/ed teleconsult50","description":"Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35122","name":"Repair artery rupture belly","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, hepatic, celiac, renal, or mesenteric artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50783","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with extensive ureteral tailoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82240","name":"Bile acids cholylglycine","description":"Bile acids; cholylglycine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3215","name":"Orthopedic ftwear ladies oxf","description":"Orthopedic footwear, ladies shoe, oxford, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46288","name":"Repair anal fistula","description":"Closure of anal fistula with rectal advancement flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72127","name":"Ct neck spine w/o & w/dye","description":"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11400","name":"Exc tr-ext b9+marg 0.5 cm<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35021","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, innominate, subclavian artery, by thoracic incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4913.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91010","name":"Esophagus motility study","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28286","name":"Repair of hammertoe","description":"Correction, cock-up fifth toe, with plastic skin closure (eg, ruiz-mora type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69667","name":"Repair middle ear structures","description":"Repair round window fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54406","name":"Remove muti-comp penis pros","description":"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27658","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27881","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula; with immediate fitting technique including application of first cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0081","name":"Care man h v ext pt 20 mi","description":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26541","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with tendon or fascial graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43108","name":"Removal of esophagus","description":"Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation and anastomosis(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3730.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59610","name":"Vbac delivery","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1974.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2996.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68761","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by plug, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15937","name":"Exc sac pr ulc prep mus ostc","description":"Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33507","name":"Repair art intramural","description":"Repair of anomalous (eg, intramural) aortic origin of coronary artery by unroofing or translocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1498.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62115","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1527.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45355","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9751.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42145","name":"Repair palate pharynx/uvula","description":"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27646","name":"Resect fibula tumor","description":"Radical resection of tumor; fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50010","name":"Renal exploration","description":"Renal exploration, not necessitating other specific procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93325","name":"Doppler echo color flow mapg","description":"Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26437","name":"Realignment of tendons","description":"Realignment of extensor tendon, hand, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47420","name":"Incision of bile duct","description":"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96153","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63057","name":"Decompress spine cord add-on","description":"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37202","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2205.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41105","name":"Biopsy of tongue","description":"Biopsy of tongue; posterior one-third","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49327","name":"Lap ins device for rt","description":"Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (list separately in addition to code for primary proced","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93924","name":"Lwr xtr vasc stdy bilat","description":"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a st","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28175","name":"Resect phalanx of toe tumor","description":"Radical resection of tumor; phalanx of toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15780","name":"Dermabrasion total face","description":"Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26725","name":"Treat finger fracture each","description":"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46940","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73723","name":"Mri joint lwr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96370","name":"Sc ther infusion addl hr","description":"Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24575","name":"Optx humeral epcndylr fx","description":"Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99466","name":"Ped crit care transport","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; first 30-74 minutes of hands-on care during transport","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42505","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83499","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50075","name":"Nl rmvl lg staghorn calculus","description":"Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54390","name":"Repair penis and bladder","description":"Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33861","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2469.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0034A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27592","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; open, circular (guillotine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25675","name":"Cltx dstl rad/uln dislc mnpj","description":"Closed treatment of distal radioulnar dislocation with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0113","name":"Pinworm examinations","description":"Pinworm examinations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85810","name":"Blood viscosity examination","description":"Viscosity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55100","name":"Drainage of scrotum abscess","description":"Drainage of scrotal wall abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64624","name":"Dstrj nulyt agt gnclr nrv","description":"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31541","name":"Larynscop w/tumr exc + scope","description":"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62368","name":"Analyze sp inf pump w/reprog","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61530","name":"Removal of brain lesion","description":"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11601","name":"Exc tr-ext mal+marg 0.6-1 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10005","name":"Fna bx w/us gdn 1st les","description":"Fine needle aspiration biopsy, including ultrasound guidance; first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20664","name":"Appl halo cranial 6+pins","description":"Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33840","name":"Exc coa w/direct anastomosis","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with direct anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1556.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61108","name":"Tdh pnxr evac&/drg sdrl hmta","description":"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65710","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); anterior lamellar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31002","name":"Irrigation sphenoid sinus","description":"Lavage by cannulation; sphenoid sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36555","name":"Insert non-tunnel cv cath","description":"Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4463.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95018","name":"All tstg perq&iq drugs/biol","description":"Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with drugs or biologicals, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","name":"Anes ther ivntl rad px icr","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88233","name":"Tissue culture skin/biopsy","description":"Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38562","name":"Removal pelvic lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1115.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54512","name":"Excise lesion testis","description":"Excision of extraparenchymal lesion of testis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29882","name":"Arthrs kne srg mnisc rpr m/l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial or lateral)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93620","name":"Comp ep evl r at ven pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"Esrd serv 4 visits p mo <2yr","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care pro","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92560","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9561","name":"Tc99m oxidronate","description":"Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47383","name":"Perq abltj lvr cryoablation","description":"Ablation, 1 or more liver tumor(s), percutaneous, cryoablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5288.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","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, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2196.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88269","name":"Chromosome analys amniotic","description":"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64760","name":"Incision of vagus nerve","description":"Transection or avulsion of; vagus nerve (vagotomy), abdominal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63615","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1206","name":"Topical fluoride varnish","description":"Topical fluoride varnish; therapeutic application for moderate to high caries risk patients","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","name":"Anes nrv msc upr a&e tnplsty","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22015","name":"I&d abscess p-spine l/s/ls","description":"Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":820.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4755","name":"Comb art/venous blood tubing","description":"Blood tubing, arterial and venous combined, for hemodialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43233","name":"Egd balloon dil esoph30 mm/>","description":"Esophagogastroduodenoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24587","name":"Optx partclr fx&/dslc elbw w","description":"Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius); with implant arthroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68325","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31720","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); nasotracheal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87271","name":"Cytomegalovirus dfa","description":"Infectious agent antigen detection by immunofluorescent technique; cytomegalovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24065","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96155","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44055","name":"Correct malrotation of bowel","description":"Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (eg, ladd procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77423","name":"Neutron beam tx complex","description":"High energy neutron radiation treatment delivery, 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge, and/or compensator(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87902","name":"Nfct agt gntyp alys hep c","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hepatitis c virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17106","name":"Dstr cut vsc prlf les<10sqcm","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57220","name":"Revision of urethra","description":"Plastic operation on urethral sphincter, vaginal approach (eg, kelly urethral plication)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61615","name":"Resect/excise lesion skull","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or c1-c3 vertebral bodies; extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2550.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":63.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78831","name":"Rp loclzj tum spect 2 areas","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84545","name":"Urea-n clearance test","description":"Urea nitrogen, clearance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2905.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":7168.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84126","name":"Assay of feces porphyrins","description":"Porphyrins, feces, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61624","name":"Tcat perm occls/embolj cns","description":"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention, percutaneous,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65275","name":"Repair of eye wound","description":"Repair of laceration; cornea, nonperforating, with or without removal foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76513","name":"Oph us dx ant sgm us uni/bi","description":"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) b-scan or high resolution biomicroscopy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91110","name":"Gi trc img intral esoph-ile","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22851","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27268","name":"Cltx thigh fx w/mnpj","description":"Closed treatment of femoral fracture, proximal end, head; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67715","name":"Canthotomy","description":"Canthotomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37224","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1722.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83893","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47350","name":"Repair liver wound","description":"Management of liver hemorrhage; simple suture of liver wound or injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP20","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1304.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24576","name":"Cltx humrl cndylr fx wo mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33645","name":"Revision of heart veins","description":"Direct or patch closure, sinus venosus, with or without anomalous pulmonary venous drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11975","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95070","name":"Inhlj brncl challenge tstg","description":"Inhalation bronchial challenge testing (not including necessary pulmonary function tests), with histamine, methacholine, or similar compounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32650","name":"Thoracoscopy w/pleurodesis","description":"Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23030","name":"I&d shoulder deep absc/hmtma","description":"Incision and drainage, shoulder area; deep abscess or hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86941","name":"Hemolysins/agglutinins","description":"Hemolysins and agglutinins; incubated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74262","name":"Ct colonography dx w/dye","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21110","name":"Interdental fixation","description":"Application of interdental fixation device for conditions other than fracture or dislocation, includes removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0184T","name":"Exc rectal tumor endoscopic","description":"Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, tems), including muscularis propria (ie, full thickness)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0166","name":"Extrnl counterpulse, per tx","description":"External counterpulsation, per treatment session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2814.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82128","name":"Amino acids mult qual","description":"Amino acids; multiple, qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99283","name":"Emergency dept visit low mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72158","name":"Mri lumbar spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24149","name":"Radical resection of elbow","description":"Radical resection of capsule, soft tissue, and heterotopic bone, elbow, with contracture release (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4657","name":"Syringe w/wo needle","description":"Syringe, with or without needle, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9277","name":"External transmitter, cgm","description":"Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66155","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; thermocauterization with iridectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99367","name":"Team conf w/o pat by phys","description":"Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47800","name":"Reconstruction of bile ducts","description":"Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1315.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78429","name":"Myocrd img pet 1 std w/ct","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58559","name":"Hysteroscopy lysis","description":"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35523","name":"Art byp grft brchl-ulnr-rdl","description":"Bypass graft, with vein; brachial-ulnar or -radial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1126.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25035","name":"Inc dp bone crtx f/arm&/wrst","description":"Incision, deep, bone cortex, forearm and/or wrist (eg, osteomyelitis or bone abscess)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32853","name":"Lung transplant double","description":"Lung transplant, double (bilateral sequential or en bloc); without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3703.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6206","name":"Contact layer <= 16 sq in","description":"Contact layer, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25825","name":"Arthrd wrist with autograft","description":"Arthrodesis, wrist; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69650","name":"Stapes mobilization","description":"Stapes mobilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27894","name":"Decompression of leg","description":"Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s), with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6208","name":"Contact layer > 48 sq in","description":"Contact layer, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32097","name":"Open wedge/bx lung nodule","description":"Thoracotomy, with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01682","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27488","name":"Removal of knee prosthesis","description":"Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1016.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75952","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43236","name":"Uppr gi scope w/submuc inj","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77078","name":"Ct bone density axial","description":"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82600","name":"Assay of cyanide","description":"Cyanide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4706","name":"Bicarbonate conc sol per gal","description":"Bicarbonate concentrate, solution, for hemodialysis, per gallon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48140","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2812.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77522","name":"Proton trmt simple w/comp","description":"Proton treatment delivery; simple, with compensation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4565.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26715","name":"Treat knuckle dislocation","description":"Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","KL","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96165","name":"Hlth bhv ivntj grp ea addl","description":"Health behavior intervention, group (2 or more patients), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50715","name":"Release of ureter","description":"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78831","name":"Rp loclzj tum spect 2 areas","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84591","name":"Assay of nos vitamin","description":"Vitamin, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41112","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; anterior two-thirds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43237","name":"Endoscopic us exam esoph","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53410","name":"Reconstruction of urethra","description":"Urethroplasty, 1-stage reconstruction of male anterior urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61888","name":"Revise/remove neuroreceiver","description":"Revision or removal of cranial neurostimulator pulse generator or receiver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29905","name":"Subtalar arthro w/exc","description":"Arthroscopy, subtalar joint, surgical; with synovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32220","name":"Release of lung","description":"Decortication, pulmonary (separate procedure); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1267.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50021","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51045","name":"Incise bladder/drain ureter","description":"Cystotomy, with insertion of ureteral catheter or stent (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97760","name":"Orthotic mgmt&traing 1st enc","description":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4301","name":"Implantable access syst perc","description":"Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26357","name":"Repair finger/hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); secondary, without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20610","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33464","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; with ring insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2119.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14021","name":"Tis trnfr s/a/l 10.1-30 sqcm","description":"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15340","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54505","name":"Biopsy of testis","description":"Biopsy of testis, incisional (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["GT","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27650","name":"Repair achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43324","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50800","name":"Implant ureter in bowel","description":"Ureteroenterostomy, direct anastomosis of ureter to intestine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4918","name":"Venous pressure clamp","description":"Venous pressure clamp, for hemodialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74270","name":"X-ray xm colon 1cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78265","name":"Gstr emptg img sm bwl trnst","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15136","name":"Drm agrft f/s/n/h/f/g/m ea","description":"Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26442","name":"Release palm & finger tendon","description":"Tenolysis, flexor tendon; palm and finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42440","name":"Excise submaxillary gland","description":"Excision of submandibular (submaxillary) gland","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80194","name":"Assay of quinidine","description":"Quinidine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87391","name":"Hiv-2 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72114","name":"X-ray exam l-s spine bending","description":"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27048","name":"Exc hip/pelv tum deep < 5 cm","description":"Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44393","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49605","name":"Repair umbilical lesion","description":"Repair of large omphalocele or gastroschisis; with or without prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4188.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2507.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63702","name":"Repair of spinal herniation","description":"Repair of meningocele; larger than 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1297.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78585","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80432","name":"Insulin suppression panel","description":"Insulin-induced c-peptide suppression panel this panel must include the following: insulin (83525) c-peptide (84681 x 5) glucose (82947 x 5)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","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, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86510","name":"Histoplasmosis skin test","description":"Skin test; histoplasmosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4261","name":"Cervical cap contraceptive","description":"Cervical cap for contraceptive use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92133","name":"Cptrzd oph dx img pst sgm on","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; optic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","name":"Anes clsd px shoulder joint","description":"Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75572","name":"Ct hrt w/3d image","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":765.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2931.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26037","name":"Decompress fingers/hand","description":"Decompressive fasciotomy, hand (excludes 26035)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28113","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; fifth metatarsal head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27257","name":"Treat hip dislocation","description":"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; with manipulation, requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","name":"Anes ther ivntl rad ven nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93452","name":"Left hrt cath w/ventrclgrphy","description":"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32670","name":"Thoracoscopy bilobectomy","description":"Thoracoscopy, surgical; with removal of two lobes (bilobectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2584.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24320","name":"Tenoplasty elbow to sho 1","description":"Tenoplasty, with muscle transfer, with or without free graft, elbow to shoulder, single (seddon-brookes type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KF","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88333","name":"Path consltj surg cyto xm 1","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47145","name":"Prep donor liver lobe split","description":"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with lobe spli","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0444","name":"Depression screen annual","description":"Annual depression screening, 5 to 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2525.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88388","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8329.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38765","name":"Remove groin lymph nodes","description":"Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97762","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75635","name":"Ct angio abdominal arteries","description":"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70542","name":"Mri orbit/face/neck w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66982","name":"Xcapsl ctrc rmvl cplx wo ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3877.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35207","name":"Rpr bld vsl dir hand finger","description":"Repair blood vessel, direct; hand, finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6806.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4480","name":"Vabra aspirator","description":"Vabra aspirator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["AU","AV","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26990","name":"Drainage of pelvis lesion","description":"Incision and drainage, pelvis or hip joint area; deep abscess or hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38720","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (complete)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96446","name":"Chemotx admn pertl cav impl","description":"Chemotherapy administration into the peritoneal cavity via implanted port or catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33881","name":"Evasc rpr ta ndgft xcov lsa","description":"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment of an aorto-aortic tube endograft not involving coverage of the left subclavian artery origin and all","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1347.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25520","name":"Cltx rdl shft fx&dislc","description":"Closed treatment of radial shaft fracture and closed treatment of dislocation of distal radioulnar joint (galeazzi fracture/dislocation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51865","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23330","name":"Remove shoulder foreign body","description":"Removal of foreign body, shoulder; subcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31368","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, with radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45150","name":"Excision of rectal stricture","description":"Division of stricture of rectum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27831","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20824","name":"Replantation thumb complete","description":"Replantation, thumb (includes carpometacarpal joint to mp joint), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44205","name":"Lap colectomy part w/ileum","description":"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37233","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4918","name":"Venous pressure clamp","description":"Venous pressure clamp, for hemodialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32097","name":"Open wedge/bx lung nodule","description":"Thoracotomy, with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95974","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49418","name":"Insert tun ip cath perc","description":"Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, contrast injection when performed, and radiological supervision and interpretation, percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35492","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8424","name":"Ready gradient sleeve","description":"Gradient pressure aid (sleeve), ready made","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57160","name":"Insert pessary/other device","description":"Fitting and insertion of pessary or other intravaginal support device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28060","name":"Partial removal foot fascia","description":"Fasciectomy, plantar fascia; partial (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96155","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61320","name":"Crnec/crnot drg icr abs sttl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1736.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"Esrd srv 2-3 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per mo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77767","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87337","name":"Entamoeb hist group ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; entamoeba histolytica group","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67415","name":"Aspiration orbital contents","description":"Fine needle aspiration of orbital contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3917.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98966","name":"Ph1 assmt&mgmt nqhp 5-10","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","name":"Anes thrc spine w/1 lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88361","name":"Tumor immunohistochem/comput","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3493.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93793","name":"Anticoag mgmt pt warfarin","description":"Anticoagulant management for a patient taking warfarin, must include review and interpretation of a new home, office, or lab international normalized ratio (inr) test result, patient instructions, dosage adjustment (as needed), and scheduling of additional test(s), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93565","name":"Njx car cth slctv lv/la ang","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00528","name":"Anes clsd ch mediast&thrc wo","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77338","name":"Design mlc device for imrt","description":"Multi-leaf collimator (mlc) device(s) for intensity modulated radiation therapy (imrt), design and construction per imrt plan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82307","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97542","name":"Wheelchair mngment training","description":"Wheelchair management (eg, assessment, fitting, training), each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49081","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80051","name":"Electrolyte panel","description":"Electrolyte panel this panel must include the following: carbon dioxide (bicarbonate) (82374) chloride (82435) potassium (84132) sodium (84295)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27882","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula; open, circular (guillotine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93284","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous impla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2004","name":"Post-d/c h vst new pt 60 m","description":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient faci","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96161","name":"Caregiver health risk assmt","description":"Administration of caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83915","name":"Assay of nucleotidase","description":"Nucleotidase 5-","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66821","name":"After cataract laser surgery","description":"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, yag laser) (1 or more stages)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86828","name":"Hla class i&ii antibody qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to hla class i and class ii hla antigens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1766.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64774","name":"Remove skin nerve lesion","description":"Excision of neuroma; cutaneous nerve, surgically identifiable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92974","name":"Cath place cardio brachytx","description":"Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1631.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35633","name":"Bpg ilio-mesenteric","description":"Bypass graft, with other than vein; ilio-mesenteric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78815","name":"Pet image w/ct skull-thigh","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; skull base to mid-thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72292","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77055","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27057","name":"Buttock fasciotomy w/dbrdmt","description":"Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle) with debridement of nonviable muscle, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4806.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92605","name":"Ex for nonspeech device rx","description":"Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43328","name":"Esoph fundoplasty thor","description":"Esophagogastric fundoplasty partial or complete; thoracotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67914","name":"Repair eyelid defect","description":"Repair of ectropion; suture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2119.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33015","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0322","name":"Home h physio data collec tr","description":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e., remote patient monitoring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91052","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23540","name":"Cltx acromclav dislc wo mnpj","description":"Closed treatment of acromioclavicular dislocation; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32556","name":"Insert cath pleura w/o image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82725","name":"Assay of blood fatty acids","description":"Fatty acids, nonesterified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","name":"Anes px arteries upr leg nos","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45541","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); perineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2416.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61250","name":"Burr hole/treph sttl expl","description":"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1082.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93290","name":"Interrog dev eval icpms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular physiologic monitor system, including analysis of 1 or more reco","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25628","name":"Optx carpl scphd fx int fixj","description":"Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8101","name":"Spacer with mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; with mask","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27635","name":"Remove lower leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30801","name":"Ablate inf turbinate superf","description":"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0003A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6018","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36223","name":"Place cath carotid/inom art","description":"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64902","name":"Nerve graft add-on","description":"Nerve graft, each additional nerve; multiple strands (cable) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96523","name":"Irrig drug delivery device","description":"Irrigation of implanted venous access device for drug delivery systems","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30140","name":"Resect inferior turbinate","description":"Submucous resection inferior turbinate, partial or complete, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23100","name":"Arthrotomy glenhumrl jt w/bx","description":"Arthrotomy, glenohumeral joint, including biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26607","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, with manipulation, with external fixation, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439T","name":"Myocrd contrast prfuj echo","description":"Myocardial contrast perfusion echocardiography, at rest or with stress, for assessment of myocardial ischemia or viability (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61517","name":"Implt brn intrcv chemotx agt","description":"Implantation of brain intracavitary chemotherapy agent (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64719","name":"Revise ulnar nerve at wrist","description":"Neuroplasty and/or transposition; ulnar nerve at wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92606","name":"Non-speech device service","description":"Therapeutic service(s) for the use of non-speech-generating device, including programming and modification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0505","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95872","name":"Ndl emg single fiber eltrd","description":"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50930","name":"Closure ureter/bowel fistula","description":"Closure of ureterovisceral fistula (including visceral repair)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":6506.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44373","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522T","name":"Prgrmg dev eval wcs ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33231","name":"Insrt pulse gen w/mult leads","description":"Insertion of implantable defibrillator pulse generator only; with existing multiple leads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65750","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in aphakia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2073.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44407","name":"Colonoscopy w/ndl aspir/bx","description":"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45346","name":"Sigmoidoscopy w/ablation","description":"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2123.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33542","name":"Removal of heart lesion","description":"Myocardial resection (eg, ventricular aneurysmectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2288.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48556","name":"Removal allograft pancreas","description":"Removal of transplanted pancreatic allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":459.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41872","name":"Gingivoplasty each quadrant","description":"Gingivoplasty, each quadrant (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35583","name":"Vein byp grft fem-popliteal","description":"In-situ vein bypass; femoral-popliteal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27570","name":"Fixation of knee joint","description":"Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66770","name":"Removal of inner eye lesion","description":"Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99448","name":"Ntrprof ph1/ntrnet/ehr 21-30","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35516","name":"Art byp grft subclav-axilary","description":"Bypass graft, with vein; subclavian-axillary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80202","name":"Assay of vancomycin","description":"Vancomycin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6012","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96156","name":"Hlth bhv assmt/reassessment","description":"Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29862","name":"Hip arthr0 w/debridement","description":"Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85415","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen activator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21813","name":"Treatment of rib fracture","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 7 or more ribs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4543","name":"Adult disp brief/diap abv xl","description":"Adult sized disposable incontinence product, protective brief/diaper, above extra large, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4868.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75984","name":"Xray control catheter change","description":"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1017.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48511","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69110","name":"Remove external ear partial","description":"Excision external ear; partial, simple repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64778","name":"Digit nerve surgery add-on","description":"Excision of neuroma; digital nerve, each additional digit (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90828","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26130","name":"Remove wrist joint lining","description":"Synovectomy, carpometacarpal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58920","name":"Partial removal of ovary(s)","description":"Wedge resection or bisection of ovary, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34813","name":"Femoral endovas graft add-on","description":"Placement of femoral-femoral prosthetic graft during endovascular aortic aneurysm repair (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8900","name":"Mra w/cont, abd","description":"Magnetic resonance angiography with contrast, abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93567","name":"Njx car cth sprvlv aortgrphy","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75562","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25515","name":"Optx radial shaft fracture","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74022","name":"Radex compl aqt abd series","description":"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11750","name":"Excision nail&nail matrix","description":"Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77370","name":"Radiation physics consult","description":"Special medical radiation physics consultation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","QB","NU","RR","QF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64402","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","name":"Anes px arteries upr leg nos","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36000","name":"Place needle in vein","description":"Introduction of needle or intracatheter, vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25290","name":"Incise wrist/forearm tendon","description":"Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43352","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36580","name":"Replace cvad cath","description":"Replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27472","name":"Repair/graft of thigh","description":"Repair, nonunion or malunion, femur, distal to head and neck; with iliac or other autogenous bone graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74241","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46270","name":"Remove anal fist subq","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33212","name":"Insert pulse gen sngl lead","description":"Insertion of pacemaker pulse generator only; with existing single lead","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50974","name":"Ureter endoscopy & biopsy","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26518","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 3 or 4 digits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21196","name":"Reconst lwr jaw w/fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87172","name":"Pinworm exam","description":"Pinworm exam (eg, cellophane tape prep)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2292","name":"Planar seat for ped size wc","description":"Seat, planar, for pediatric size wheelchair including fixed attaching hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","name":"Anes hrna rpr<37wk brth<50","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74262","name":"Ct colonography dx w/dye","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29540","name":"Strapping ankle &/foot","description":"Strapping; ankle and/or foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82649","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93018","name":"Cv stress test i&r only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92993","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28406","name":"Prq skel fix clcnl fx w/mnpj","description":"Percutaneous skeletal fixation of calcaneal fracture, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88237","name":"Tissue culture bone marrow","description":"Tissue culture for neoplastic disorders; bone marrow, blood cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95715","name":"Veeg ea 12-26hr intmt mntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, each increment of 12-26 hours; with intermittent monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26720","name":"Treat finger fracture each","description":"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; without manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97139","name":"Unlisted therapeutic px","description":"Unlisted therapeutic procedure (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31084","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75945","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49520","name":"Rerepair ing hernia reduce","description":"Repair recurrent inguinal hernia, any age; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57265","name":"Cmbn ap colprhy w/ntrcl rpr","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43191","name":"Esophagoscopy rigid trnso dx","description":"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95870","name":"Ndl emg lmtd std musc 1 xtr","description":"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99461","name":"Init nb em per day non-fac","description":"Initial care, per day, for evaluation and management of normal newborn infant seen in other than hospital or birthing center","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47361","name":"Repair liver wound","description":"Management of liver hemorrhage; exploration of hepatic wound, extensive debridement, coagulation and/or suture, with or without packing of liver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2527.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64822","name":"Sympathectomy ulnar artery","description":"Sympathectomy; ulnar artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1753","name":"Cath, intravas ultrasound","description":"Catheter, intravascular ultrasound","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32408","name":"Core ndl bx lng/med perq","description":"Core needle biopsy, lung or mediastinum, percutaneous, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43338","name":"Esoph lengthening","description":"Esophageal lengthening procedure (eg, collis gastroplasty or wedge gastroplasty) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84307","name":"Assay of somatostatin","description":"Somatostatin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83088","name":"Assay of histamine","description":"Histamine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67112","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21315","name":"Clsd tx nsl fx mnpj wo stblj","description":"Closed treatment of nasal bone fracture with manipulation; without stabilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2061.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44500","name":"Intro gastrointestinal tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61450","name":"Crnec stpl sctj cmprn/dcmprn","description":"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1760.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25526","name":"Optx rdl shft fx&dstl rad/ul","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (galeazzi fracture/ dislocation), includes internal fixation, when performed, includes repair of triangular fibrocartilage complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38555","name":"Removal neck/armpit lesion","description":"Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82775","name":"Assay galactose transferase","description":"Galactose-1-phosphate uridyl transferase; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3222","name":"Mens shoes hightop depth inl","description":"Orthopedic footwear, mens shoe, hightop, depth inlay, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4583.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":8699.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92228","name":"Img rta detc/mntr ds phy/qhp","description":"Imaging of retina for detection or monitoring of disease; with remote physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2534.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76936","name":"Echo guide for artery repair","description":"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42955","name":"Surgical opening of throat","description":"Pharyngostomy (fistulization of pharynx, external for feeding)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64448","name":"Njx aa&/strd fem nrv nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87273","name":"Herpes simplex 2 ag if","description":"Infectious agent antigen detection by immunofluorescent technique; herpes simplex virus type 2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21282","name":"Lateral canthopexy","description":"Lateral canthopexy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12055","name":"Intmd rpr face/mm 12.6-20 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97811","name":"Acup 1/> w/o estim ea add 15","description":"Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27327","name":"Exc thigh/knee les sc < 3 cm","description":"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1431.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01230","name":"Anes opn upper 2/3 femur nos","description":"Anesthesia for open procedures involving upper two-thirds of femur; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84154","name":"Assay of psa free","description":"Prostate specific antigen (psa); free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50021","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":52.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27602","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49040","name":"Drain open abdom abscess","description":"Drainage of subdiaphragmatic or subphrenic abscess, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92611","name":"Motion fluoroscopy/swallow","description":"Motion fluoroscopic evaluation of swallowing function by cine or video recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1860.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93290","name":"Interrog dev eval icpms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular physiologic monitor system, including analysis of 1 or more reco","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37160","name":"Revision of circulation","description":"Venous anastomosis, open; caval-mesenteric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35883","name":"Revj fem anast nonautog grf","description":"Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63048","name":"Lam facetec &foramot ea addl","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional vertebral segment, cervical, thoracic, or lumbar (list separately in addition t","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10028.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67101","name":"Repair detached retina crtx","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17000","name":"Destruct premalg lesion","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0891","name":"Pwc gp5 ped mult pow opt s/b","description":"Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2184.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44135","name":"Intestine transplnt cadaver","description":"Intestinal allotransplantation; from cadaver donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0244","name":"Toilet seat raised","description":"Raised toilet seat","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58145","name":"Myomectomy vag method","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47125","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total left lobectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2580.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74175","name":"Cta abdomen w/contrast","description":"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77767","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1441.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86359","name":"T cells total count","description":"T cells; total count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3005.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"Esrd home pt serv p mo 20+","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 20 years of age and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69530","name":"Extensive mastoid surgery","description":"Petrous apicectomy including radical mastoidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32400","name":"Needle biopsy chest lining","description":"Biopsy, pleura, percutaneous needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48148","name":"Removal of pancreatic duct","description":"Excision of ampulla of vater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9868","name":"Cmmi asyntelehealth <10min","description":"Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, less than 10 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80414","name":"Testosterone response panel","description":"Chorionic gonadotropin stimulation panel; testosterone response this panel must include the following: testosterone (84403 x 2 on 3 pooled blood samples)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50541","name":"Laparo ablate renal cyst","description":"Laparoscopy, surgical; ablation of renal cysts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91013","name":"Esophgl motil w/stim/perfus","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25023","name":"Decompress forearm 1 space","description":"Decompression fasciotomy, forearm and/or wrist, flexor or extensor compartment; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58260","name":"Vaginal hysterectomy","description":"Vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64782","name":"Remove limb nerve lesion","description":"Excision of neuroma; hand or foot, except digital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78453","name":"Ht muscle image planar sing","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94070","name":"Evaluation of wheezing","description":"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27093","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36262","name":"Removal of infusion pump","description":"Removal of implanted intra-arterial infusion pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91037","name":"Esoph imped function test","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31622","name":"Dx bronchoscope/wash","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2273.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61316","name":"Inc&subq plmt crnl bone grf","description":"Incision and subcutaneous placement of cranial bone graft (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83919","name":"Organic acids qual each","description":"Organic acids; qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25355","name":"Revision of radius","description":"Osteotomy, radius; middle or proximal third","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91037","name":"Esoph imped function test","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27254","name":"Treat hip dislocation","description":"Open treatment of hip dislocation, traumatic, with acetabular wall and femoral head fracture, with or without internal or external fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1079.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64463","name":"Pvb thoracic cont infusion","description":"Paravertebral block (pvb) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92561","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1766.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28531","name":"Treat sesamoid bone fracture","description":"Open treatment of sesamoid fracture, with or without internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4673","name":"Ext line w easy lock connect","description":"Extension line with easy lock connectors, used with dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50544","name":"Laparoscopy pyeloplasty","description":"Laparoscopy, surgical; pyeloplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43229","name":"Esophagoscopy lesion ablate","description":"Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58280","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","name":"Anes px arteries upr leg nos","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23420","name":"Repair of shoulder","description":"Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57400","name":"Dilation of vagina","description":"Dilation of vagina under anesthesia (other than local)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19330","name":"Rmvl ruptured breast implant","description":"Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","name":"Anes thoracotomy px nos","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85245","name":"Clot factor viii vw ristoctn","description":"Clotting; factor viii, vw factor, ristocetin cofactor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51772","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29049","name":"Appl cast figure-of-eight","description":"Application, cast; figure-of-eight","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82075","name":"Assay of breath ethanol","description":"Alcohol (ethanol); breath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87071","name":"Culture aerobic quant other","description":"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33511","name":"Cabg vein two","description":"Coronary artery bypass, vein only; 2 coronary venous grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1846.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35400","name":"Angioscopy","description":"Angioscopy (noncoronary vessels or grafts) during therapeutic intervention (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22854","name":"Insj biomechanical device","description":"Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63304","name":"Remove vert idrl body crvcl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0076","name":"Care manag h vst new pt 20 m","description":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2039.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27519","name":"Treat thigh fx growth plate","description":"Open treatment of distal femoral epiphyseal separation, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25135","name":"Remove & graft wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55060","name":"Repair of hydrocele","description":"Repair of tunica vaginalis hydrocele (bottle type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2102.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21275","name":"Revision orbitofacial bones","description":"Secondary revision of orbitocraniofacial reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43772","name":"Lap rmvl gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8555.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89235","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11621","name":"Exc s/n/h/f/g mal+mrg 0.6-1","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36591","name":"Draw blood off venous device","description":"Collection of blood specimen from a completely implantable venous access device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64892","name":"Nrv grf 1strnd arm/leg <4cm","description":"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","name":"Anes px nrv msc upr a&e tnot","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35452","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43210","name":"Egd esophagogastrc fndoplsty","description":"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54520","name":"Removal of testis","description":"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76950","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46746","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3278.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81185","name":"Cacna1a gene full gene seq","description":"Cacna1a (calcium voltage-gated channel subunit alpha1 a) (eg, spinocerebellar ataxia) gene analysis; full gene sequence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54322","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, magpi, v-flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67904","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90739","name":"Hepb vacc 2/4 dose adult im","description":"Hepatitis b vaccine (hepb), cpg-adjuvanted, adult dosage, 2 dose or 4 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93621","name":"Comp ep evl l pac&rec c sins","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1779.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0171T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4652","name":"Microcapillary tube sealant","description":"Microcapillary tube sealant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45005","name":"Drainage of rectal abscess","description":"Incision and drainage of submucosal abscess, rectum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0475","name":"Hiv combination assay","description":"Hiv antigen/antibody, combination assay, screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22840","name":"Insert spine fixation device","description":"Posterior non-segmental instrumentation (eg, harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at c1, facet screw fixation) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49441","name":"Place duod/jej tube perc","description":"Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37221","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2160.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44125","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; with enterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96002","name":"Dynamic surface emg","description":"Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86710","name":"Influenza virus antibody","description":"Antibody; influenza virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28070","name":"Removal of foot joint lining","description":"Synovectomy; intertarsal or tarsometatarsal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88386","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","name":"Anes integ sys rad brst dsj","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86580","name":"Tb intradermal test","description":"Skin test; tuberculosis, intradermal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23182","name":"Prtl excision bone scapula","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86904","name":"Blood typing patient serum","description":"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36591","name":"Draw blood off venous device","description":"Collection of blood specimen from a completely implantable venous access device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19535.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68770","name":"Close tear system fistula","description":"Closure of lacrimal fistula (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50980","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85385","name":"Fibrinogen antigen","description":"Fibrinogen; antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0281","name":"Elec stim unattend for press","description":"Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27822","name":"Treatment of ankle fracture","description":"Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; without fixation of posterior lip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43204","name":"Esoph scope w/sclerosis inj","description":"Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11606","name":"Exc tr-ext mal+marg >4 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19082","name":"Bx breast add lesion strtctc","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including stereotactic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4103","name":"Ef ped fluid and electrolyte","description":"Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5299.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1725","name":"Cath, translumin non-laser","description":"Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67971","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93514","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93293","name":"Pm phone r-strip device eval","description":"Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8839.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"Demo&/eval pt use inhaler","description":"Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or ippb device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3412.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82759","name":"Assay of rbc galactokinase","description":"Galactokinase, rbc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23044","name":"Arthrt ac sc jt exp/rmvl fb","description":"Arthrotomy, acromioclavicular, sternoclavicular joint, including exploration, drainage, or removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4808.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39401","name":"Mediastinoscpy w/medstnl bx","description":"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27230","name":"Treat thigh fracture","description":"Closed treatment of femoral fracture, proximal end, neck; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32670","name":"Thoracoscopy bilobectomy","description":"Thoracoscopy, surgical; with removal of two lobes (bilobectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27430","name":"Revision of thigh muscles","description":"Quadricepsplasty (eg, bennett or thompson type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69676","name":"Remove middle ear nerve","description":"Tympanic neurectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0147T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93288","name":"Interrog evl pm/ldls pm ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system, or leadless pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62164","name":"Remove brain tumor w/scope","description":"Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88312","name":"Special stains group 1","description":"Special stain including interpretation and report; group i for microorganisms (eg, acid fast, methenamine silver)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88166","name":"Cytopath tbs c/v auto redo","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and computer-assisted rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22845","name":"Insert spine fixation device","description":"Anterior instrumentation; 2 to 3 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45386","name":"Colonoscopy w/balloon dilat","description":"Colonoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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 (","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32150","name":"Removal of lung lesion(s)","description":"Thoracotomy; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33548","name":"Restore/remodel ventricle","description":"Surgical ventricular restoration procedure, includes prosthetic patch, when performed (eg, ventricular remodeling, svr, saver, dor procedures)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36815","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78815","name":"Pet image w/ct skull-thigh","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; skull base to mid-thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77031","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0269","name":"Occlusive device in vein art","description":"Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71551","name":"Mri chest w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0077","name":"Care manag h vst new pt 30 m","description":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26560","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44133","name":"Enterectomy live donor","description":"Donor enterectomy (including cold preservation), open; partial, from living donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76125","name":"Cine/video x-rays add-on","description":"Cineradiography/videoradiography to complement routine examination (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78272","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92601","name":"Cochlear implt f/up exam <7","description":"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":116.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32997","name":"Total lung lavage","description":"Total lung lavage (unilateral)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0312","name":"Immunize couns < 21yr 5-15 m","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22216","name":"Incis addl spine segment","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91037","name":"Esoph imped function test","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31785","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53250","name":"Removal of urethra gland","description":"Excision of bulbourethral gland (cowpers gland)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0172T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5307.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35884","name":"Revj fem anast autog vn grf","description":"Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with autogenous vein patch graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41820","name":"Excision gum each quadrant","description":"Gingivectomy, excision gingiva, each quadrant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54111","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft to 5 cm in length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]},{"negotiated_type":"negotiated","negotiated_rate":602.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22850","name":"Remove spine fixation device","description":"Removal of posterior nonsegmental instrumentation (eg, harrington rod)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29873","name":"Arthrs knee surg w/lat rls","description":"Arthroscopy, knee, surgical; with lateral release","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95904","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1921.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33369","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28810","name":"Amputation toe & metatarsal","description":"Amputation, metatarsal, with toe, single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87801","name":"Detect agnt mult dna ampli","description":"Infectious agent detection by nucleic acid (dna or rna), multiple organisms; amplified probe(s) technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2169.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25028","name":"I&d f/arm&/wrst dp absc/hmtm","description":"Incision and drainage, forearm and/or wrist; deep abscess or hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4641","name":"Radiopharm dx agent noc","description":"Radiopharmaceutical, diagnostic, not otherwise classified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66130","name":"Remove eye lesion","description":"Excision of lesion, sclera","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43286","name":"Esphg tot w/laps moblj","description":"Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, laparoscopic transhiatal esophagectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2627.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21206","name":"Reconstruct upper jaw bone","description":"Osteotomy, maxilla, segmental (eg, wassmund or schuchard)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65778","name":"Cover eye w/membrane","description":"Placement of amniotic membrane on the ocular surface; without sutures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23150","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3914.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96137","name":"Psycl/nrpsyc tst phy/qhp ea","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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 (","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38204","name":"Bl donor search management","description":"Management of recipient hematopoietic progenitor cell donor search and cell acquisition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75676","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5469.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39421.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64727","name":"Internal neurolysis","description":"Internal neurolysis, requiring use of operating microscope (list separately in addition to code for neuroplasty) (neuroplasty includes external neurolysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01180","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97163","name":"Pt eval high complex 45 min","description":"Physical therapy evaluation: high complexity, requiring these components: a history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; an examination of body systems using standardized tests and measures addressing a total of 4 or more elements from","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6025","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14696.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01130","name":"Anes body cast appl/revj","description":"Anesthesia for body cast application or revision","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4208","name":"3 cc sterile syringe&needle","description":"Syringe with needle, sterile 3 cc, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"Ther/proph/diag inj sc/im","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22524","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":175.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12037","name":"Intmd rpr s/tr/ext >30.0 cm","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); over 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93296","name":"Rem interrog evl pm/ids","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, leadless pacemaker system, or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23540","name":"Cltx acromclav dislc wo mnpj","description":"Closed treatment of acromioclavicular dislocation; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94660","name":"Cpap initiation&mgmt","description":"Continuous positive airway pressure ventilation (cpap), initiation and management","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31820","name":"Closure of windpipe lesion","description":"Surgical closure tracheostomy or fistula; without plastic repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43030","name":"Cricopharyngeal myotomy","description":"Cricopharyngeal myotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93501","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75558","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":784.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53447","name":"Remove/replace ur sphincter","description":"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26145","name":"Tendon excision palm/finger","description":"Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43258","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21400","name":"Closed tx orbit w/o manipulj","description":"Closed treatment of fracture of orbit, except blowout; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00792","name":"Anes iper upr abd prtl hptc","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; partial hepatectomy or management of liver hemorrhage (excluding liver biopsy)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95887","name":"Musc tst done w/n tst nonext","description":"Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27385","name":"Repair of thigh muscle","description":"Suture of quadriceps or hamstring muscle rupture; primary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44660","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; without intestinal or bladder resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11200","name":"Rmvl skin tags up to&inc 15","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59400","name":"Obstetrical care","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30117","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; internal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86920","name":"Compatibility test spin","description":"Compatibility test each unit; immediate spin technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33974","name":"Remove intra-aortic balloon","description":"Removal of intra-aortic balloon assist device from the ascending aorta, including repair of the ascending aorta, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29800","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21310","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64755","name":"Incision of stomach nerves","description":"Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76145","name":"Med physic dos eval rad exps","description":"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33952","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81284","name":"Fxn gene detc abnor alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82482","name":"Assay rbc cholinesterase","description":"Cholinesterase; rbc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8686","name":"Implt nrostm pls gen sng non","description":"Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4064.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33282","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15828","name":"Rhytidectomy cheek chn & nck","description":"Rhytidectomy; cheek, chin, and neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27325","name":"Neurectomy hamstring","description":"Neurectomy, hamstring muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31587","name":"Laryngoplasty cricoid split","description":"Laryngoplasty, cricoid split, without graft placement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27560","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67015","name":"Release of eye fluid","description":"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63200","name":"Release spinal cord lumbar","description":"Laminectomy, with release of tethered spinal cord, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77078","name":"Ct bone density axial","description":"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12052","name":"Intmd rpr face/mm 2.6-5.0 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93641","name":"Ep evl 1/2chmb pac cvdfb tst","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25922","name":"Amputate hand at wrist","description":"Disarticulation through wrist; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38200","name":"Injection for spleen x-ray","description":"Injection procedure for splenoportography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27428","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0277","name":"Hbot, full body chamber, 30m","description":"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70480","name":"Ct orbit/ear/fossa w/o dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9560","name":"Tc99m labeled rbc","description":"Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62324","name":"Njx interlaminar crv/thrc","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thorac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0086","name":"Care man home care plan 30 m","description":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27250","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82715","name":"Assay of fecal fat","description":"Fat differential, feces, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50557","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9612","name":"Catheterize for urine spec","description":"Catheterization for collection of specimen, single patient, all places of service","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1803.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78451","name":"Ht muscle image spect sing","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60300","name":"Aspir/inj thyroid cyst","description":"Aspiration and/or injection, thyroid cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64611","name":"Chemodenerv saliv glands","description":"Chemodenervation of parotid and submandibular salivary glands, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4383.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97755","name":"Assistive technology assess","description":"Assistive technology assessment (eg, to restore, augment or compensate for existing function, optimize functional tasks and/or maximize environmental accessibility), direct one-on-one contact, with written report, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L8010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33222","name":"Relocation pocket pacemaker","description":"Relocation of skin pocket for pacemaker","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96420","name":"Chemo ia push tecnique","description":"Chemotherapy administration, intra-arterial; push technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44626","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of hartmann type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1321.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75559","name":"Cardiac mri w/stress img","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90862","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95920","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23332","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31633","name":"Bronchoscopy/needle bx addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6201","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11922","name":"Correct skin color ea 20.0cm","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; each additional 20.0 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90468","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72083","name":"X-ray exam entire spi 4/5 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47480","name":"Incision of gallbladder","description":"Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57455","name":"Biopsy of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78594","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25136","name":"Remove & graft wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75893","name":"Venous sampling by catheter","description":"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99231","name":"Sbsq hosp ip/obs sf/low 25","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selec","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92083","name":"Extended visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, hump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27519","name":"Treat thigh fx growth plate","description":"Open treatment of distal femoral epiphyseal separation, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75560","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35011","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, axillary-brachial artery, by arm incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21743","name":"Repair sternum/nuss w/scope","description":"Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (nuss procedure), with thoracoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61151","name":"Burr hole/treph sbsq tapping","description":"Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54105","name":"Biopsy of penis","description":"Biopsy of penis; deep structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93985","name":"Dup-scan hemo compl bi std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19396","name":"Design custom breast implant","description":"Preparation of moulage for custom breast implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3615.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330T","name":"Tear film img uni/bi w/i&r","description":"Tear film imaging, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92625","name":"Tinnitus assessment","description":"Assessment of tinnitus (includes pitch, loudness matching, and masking)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51596","name":"Remove bladder/create pouch","description":"Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1905.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6146.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":7836.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1754.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99409","name":"Audit/dast over 30 min","description":"Alcohol and/or substance (other than tobacco) abuse structured screening (eg, audit, dast), and brief intervention (sbi) services; greater than 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23545","name":"Cltx acromclav dislc w/mnpj","description":"Closed treatment of acromioclavicular dislocation; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26055","name":"Incise finger tendon sheath","description":"Tendon sheath incision (eg, for trigger finger)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27238","name":"Treat thigh fracture","description":"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84583","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; semiquantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50390","name":"Drainage of kidney lesion","description":"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44139","name":"Mobilization of colon","description":"Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1843.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31582","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1407.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95148","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 4 single stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26863","name":"Fuse/graft added joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft), each additional joint (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50948","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35201","name":"Repair blood vessel dir neck","description":"Repair blood vessel, direct; neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":820.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84425","name":"Assay of vitamin b-1","description":"Thiamine (vitamin b-1)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78496","name":"Heart first pass add-on","description":"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19001","name":"Puncture aspir cyst brst ea","description":"Puncture aspiration of cyst of breast; each additional cyst (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4445.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34830","name":"Open aortic tube prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; tube prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1558.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"Vnpnxr<3yrs phy/qhp other vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; other vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","name":"Anes all px neck nos 1yr/>","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0031A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52310","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67901","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99452","name":"Ntrprof ph1/ntrnet/ehr rfrl","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62100","name":"Repair brain fluid leakage","description":"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1413.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","name":"Anes thrcm px trach&bronchi","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea and bronchi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4490","name":"Above knee surgical stocking","description":"Surgical stockings above knee length, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32215","name":"Treat chest lining","description":"Pleural scarification for repeat pneumothorax","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25491","name":"Prophylactic tx ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61546","name":"Removal of pituitary gland","description":"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2118.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57156","name":"Ins vag brachytx device","description":"Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27391","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, 1 leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77785","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32562","name":"Lyse chest fibrin subq day","description":"Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); subsequent day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3619.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45130","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; perineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85445","name":"Heinz bodies induced","description":"Heinz bodies; induced, acetyl phenylhydrazine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45303","name":"Proctosigmoidoscopy dilate","description":"Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93282","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39402","name":"Mediastinoscpy w/lmph nod bx","description":"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84106","name":"Test for porphobilinogen","description":"Porphobilinogen, urine; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99489","name":"Cplx chrnc care ea addl 30","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22858","name":"Tot disc arthrp 2nd lvl crv","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52281","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33802","name":"Division aberrant vessel","description":"Division of aberrant vessel (vascular ring);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9870","name":"Cmmi asyntelehealth >20min","description":"Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, more than 20 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29915","name":"Hip arthro acetabuloplasty","description":"Arthroscopy, hip, surgical; with acetabuloplasty (ie, treatment of pincer lesion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31653","name":"Bronch ebus samplng 3/> node","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2215.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93050","name":"Art pressure waveform analys","description":"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity art","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62270","name":"Dx lmbr spi pnxr","description":"Spinal puncture, lumbar, diagnostic;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85301","name":"Antithrombin iii antigen","description":"Clotting inhibitors or anticoagulants; antithrombin iii, antigen assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","name":"Anes xtnsv sp&spi cord px","description":"Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84275","name":"Assay of sialic acid","description":"Sialic acid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82139","name":"Amino acids quan 6 or more","description":"Amino acids, 6 or more amino acids, quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83491","name":"Asy hydroxycorticosteroids17","description":"Hydroxycorticosteroids, 17- (17-ohcs)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59151","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0332","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4305","name":"Drug delivery system >=50 ml","description":"Disposable drug delivery system, flow rate of 50 ml or greater per hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4772","name":"Blood glucose test strips","description":"Blood glucose test strips, for dialysis, per 50","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50080","name":"Perq nl/pl lithotrp smpl<2cm","description":"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; simple (eg, stone[s] up to 2 cm in single location of kidney or renal pelvis, nonbranching ston","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3368.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46260","name":"Remove in/ex hem groups 2+","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63199","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2006.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30450","name":"Revision of nose","description":"Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1327.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67015","name":"Release of eye fluid","description":"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34718","name":"Evasc rpr n/a a-iliac ndgft","description":"Endovascular repair of iliac artery, not associated with placement of an aorto-iliac artery endograft at the same session, by deployment of an iliac branched endograft, including pre-procedure sizing and device selection, all ipsilateral selective iliac artery catheterization(s), all associated radi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42260","name":"Repair nose to lip fistula","description":"Repair of nasolabial fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29884","name":"Arthrs knee surg lysis ads","description":"Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","name":"Anes open/arthr ntrthrc amp","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; interthoracoscapular (forequarter) amputation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48545","name":"Pancreatorrhaphy","description":"Pancreatorrhaphy for injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1128.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20902","name":"Removal of bone for graft","description":"Bone graft, any donor area; major or large","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31725","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); tracheobronchial with fiberscope, bedside","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92133","name":"Cptrzd oph dx img pst sgm on","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; optic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30120","name":"Revision of nose","description":"Excision or surgical planing of skin of nose for rhinophyma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56501","name":"Destroy vulva lesions sim","description":"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80047","name":"Basic metablc pnl ionized ca","description":"Basic metabolic panel (calcium, ionized) this panel must include the following: calcium, ionized (82330) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35481","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61606","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2620.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5480.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6393.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22846","name":"Insert spine fixation device","description":"Anterior instrumentation; 4 to 7 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83840","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37616","name":"Ligation major artery chest","description":"Ligation, major artery (eg, post-traumatic, rupture); chest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93788","name":"Ambl bp mntr w/sw a/r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; scanning analysis with report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14301","name":"Tis trnfr any 30.1-60 sq cm","description":"Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78227","name":"Hepatobil syst image w/drug","description":"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25115","name":"Remove wrist/forearm lesion","description":"Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, tbc, or other granulomas, rheumatoid arthritis); flexors","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84512","name":"Assay of troponin qual","description":"Troponin, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12045","name":"Intmd rpr n-hf/genit12.6-20","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10140","name":"I&d hmtma seroma/fluid collj","description":"Incision and drainage of hematoma, seroma or fluid collection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11643","name":"Exc f/e/e/n/l mal+mrg 2.1-3","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":106.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26428","name":"Repair/graft finger tendon","description":"Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); with free graft (includes obtaining graft), each finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28515","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11103","name":"Tangntl bx skin ea sep/addl","description":"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); each separate/additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP23","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92992","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27040","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27049","name":"Resect hip/pelv tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33781","name":"Rpr tga rcnstj rpr sbpl obst","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with repair of subpulmonic obstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2017.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35132","name":"Repair artery rupture groin","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, iliac artery (common, hypogastric, external)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01610","name":"Anes all px nrv musc sho&ax","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21122","name":"Geniop sldg osteot 2/>","description":"Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26841","name":"Fusion of thumb","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521T","name":"Interrog dev eval wcs ip","description":"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85675","name":"Thrombin time titer","description":"Thrombin time; titer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4213","name":"20+ cc syringe only","description":"Syringe, sterile, 20 cc or greater, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25650","name":"Cltx ulnar styloid fracture","description":"Closed treatment of ulnar styloid fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1039.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31000","name":"Irrigation maxillary sinus","description":"Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27499","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, multiple compartments; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1887.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33405","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1973.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35531","name":"Art byp grft aorcel/aormesen","description":"Bypass graft, with vein; aortoceliac or aortomesenteric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98942","name":"Chiropractic manj 5 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 5 regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21400","name":"Closed tx orbit w/o manipulj","description":"Closed treatment of fracture of orbit, except blowout; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0218T","name":"Njx paravert w/us lumb/sac","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; third and any additional level(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4721","name":"Dialysat sol fld vol > 999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4154","name":"Ef spec metabolic noninherit","description":"Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31570","name":"Laryngoscope w/vc inj","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69205","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; with general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46946","name":"Int hrhc lig 2+hroid w/o img","description":"Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43219","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46604","name":"Anoscopy and dilation","description":"Anoscopy; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73222","name":"Mri joint upr extrem w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92316","name":"C-lens fitg tech aphakia ou","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, both eyes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54380","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94642","name":"Aerosol inhalation treatment","description":"Aerosol inhalation of pentamidine for pneumocystis carinii pneumonia treatment or prophylaxis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32151","name":"Remove lung foreign body","description":"Thoracotomy; with removal of intrapulmonary foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47100","name":"Wedge biopsy of liver","description":"Biopsy of liver, wedge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2869.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","name":"Anes opn/arthrs px elbw nos","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92312","name":"Contact lens fitg aphakia ou","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, both eyes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54692","name":"Laparoscopy orchiopexy","description":"Laparoscopy, surgical; orchiopexy for intra-abdominal testis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61000","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72084","name":"X-ray exam entire spi 6/> vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4651","name":"Calibrated microcap tube","description":"Calibrated microcapillary tube, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46030","name":"Removal anal seton oth mrk","description":"Removal of anal seton, other marker","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":544.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80195","name":"Assay of sirolimus","description":"Sirolimus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90657","name":"Iiv3 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76937","name":"Us guide vascular access","description":"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92325","name":"Modification of contact lens","description":"Modification of contact lens (separate procedure), with medical supervision of adaptation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23073","name":"Exc shoulder tum deep 5 cm/>","description":"Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70492","name":"Ct sft tsue nck w/o & w/dye","description":"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6206","name":"Contact layer <= 16 sq in","description":"Contact layer, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78803","name":"Rp loclzj tum spect 1 area","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92326","name":"Replacement of contact lens","description":"Replacement of contact lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82486","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93248","name":"Ext ecg>7d<15d rev&interpj","description":"External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; review and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2599","name":"Sgd accessory noc","description":"Accessory for speech generating device, not otherwise classified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61582","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2757.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95075","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":553.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27888","name":"Amputation of foot at ankle","description":"Amputation, ankle, through malleoli of tibia and fibula (eg, syme, pirogoff type procedures), with plastic closure and resection of nerves","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93790","name":"Ambl bp mntr w/sw i&r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; review with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98962","name":"Edu&trn pt slf-mgmt nqhp 5-8","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 5-8 patients","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33925","name":"Rpr pul art unifocal w/o cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50230","name":"Removal kidney open radical","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48500","name":"Surgery of pancreatic cyst","description":"Marsupialization of pancreatic cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68020","name":"Incise/drain eyelid lining","description":"Incision of conjunctiva, drainage of cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97124","name":"Massage therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29240","name":"Strapping of shoulder","description":"Strapping; shoulder (eg, velpeau)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33518","name":"Cabg artery-vein two","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 2 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76506","name":"Echo exam of head","description":"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25150","name":"Partial removal of ulna","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36569","name":"Insj picc 5 yr+ w/o imaging","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, without imaging guidance; age 5 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61545","name":"Excision of brain tumor","description":"Craniotomy with elevation of bone flap; for excision of craniopharyngioma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2940.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93571","name":"Iv dop vel&/press c flo 1st","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; initial vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99478","name":"Sbsq ic vlbw inf<1,500 gm","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering very low birth weight infant (present body weight less than 1,500 grams)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64430","name":"Njx aa&/strd pudendal nerve","description":"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26478","name":"Lengthening of hand tendon","description":"Lengthening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24430","name":"Rpr non/mal humerus wo graft","description":"Repair of nonunion or malunion, humerus; without graft (eg, compression technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":891.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63101","name":"Remove vert body dcmprn thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic, single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2091.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84228","name":"Assay of quinine","description":"Quinine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61571","name":"Incise skull for brain wound","description":"Craniectomy or craniotomy; with treatment of penetrating wound of brain","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57452","name":"Exam of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90581","name":"Anthrax vaccine sc or im","description":"Anthrax vaccine, for subcutaneous or intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21159","name":"Rcnst mdfc lfrtiii advm wo i","description":"Reconstruction midface, lefort iii (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); without lefort i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2119.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57285","name":"Repair paravag defect vag","description":"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21160","name":"Rcnst mdfc lfrtiii advm w/i","description":"Reconstruction midface, lefort iii (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); with lefort i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21139","name":"Rdctj forehead cntrg&setback","description":"Reduction forehead; contouring and setback of anterior frontal sinus wall","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4803.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15044.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61735","name":"Incise skull/brain surgery","description":"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1453.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2003","name":"Post-d/c h vst new pt 45 m","description":"Moderate (45 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2169.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15297.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25426","name":"Repair/graft radius & ulna","description":"Repair of defect with autograft; radius and ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2291","name":"Planar back for ped size wc","description":"Back, planar, for pediatric size wheelchair including fixed attaching hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63600","name":"Remove spinal cord lesion","description":"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0109T","name":"Heat quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using heat-pain stimuli to assess small nerve fiber sensation and hyperalgesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57111","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2526.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33741","name":"Tas congenital car anomal","description":"Transcatheter atrial septostomy (tas) for congenital cardiac anomalies to create effective atrial flow, including all imaging guidance by the proceduralist, when performed, any method (eg, rashkind, sang-park, balloon, cutting balloon, blade)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74022","name":"Radex compl aqt abd series","description":"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67414","name":"Explr/decompress eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30540","name":"Rpr choanal atresia ntranasl","description":"Repair choanal atresia; intranasal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43314","name":"Tracheo-esophagoplasty cong","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; with repair of congenital tracheoesophageal fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2445.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57170","name":"Fitting of diaphragm/cap","description":"Diaphragm or cervical cap fitting with instructions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76881","name":"Us compl joint r-t w/img","description":"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1754.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96425","name":"Chemotherapy infusion method","description":"Chemotherapy administration, intra-arterial; infusion technique, initiation of prolonged infusion (more than 8 hours), requiring the use of a portable or implantable pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36570","name":"Insert picvad cath","description":"Insertion of peripherally inserted central venous access device, with subcutaneous port; younger than 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":129.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11951","name":"Subq njx fil matrl 1.1-5.0cc","description":"Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71271","name":"Ct thorax lung cancer scr c-","description":"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27258","name":"Treat hip dislocation","description":"Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62116","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58720","name":"Removal of ovary/tube(s)","description":"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35686","name":"Bypass graft/av fist patency","description":"Creation of distal arteriovenous fistula during lower extremity bypass surgery (non-hemodialysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27447","name":"Total knee arthroplasty","description":"Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1148.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":714.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3524.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49550","name":"Rpr rem hernia init reduce","description":"Repair initial femoral hernia, any age; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82952","name":"Gtt-added samples","description":"Glucose; tolerance test, each additional beyond 3 specimens (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34401","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48020","name":"Removal of pancreatic stone","description":"Removal of pancreatic calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48547","name":"Duodenal exclusion","description":"Duodenal exclusion with gastrojejunostomy for pancreatic injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1506.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66500","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); except transfixion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58553","name":"Laparo-vag hyst complex","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23150","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86147","name":"Cardiolipin antibody ea ig","description":"Cardiolipin (phospholipid) antibody, each ig class","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75559","name":"Cardiac mri w/stress img","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2305.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93460","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S2083","name":"Adjustment gastric band","description":"Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30901","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32654","name":"Thoracoscopy contrl bleeding","description":"Thoracoscopy, surgical; with control of traumatic hemorrhage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":914.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50570","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71035","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43193","name":"Esophagoscp rig trnso biopsy","description":"Esophagoscopy, rigid, transoral; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61500","name":"Crnec exc tum/bone les skull","description":"Craniectomy; with excision of tumor or other bone lesion of skull","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20939","name":"Bone marrow aspir bone grfg","description":"Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0114","name":"Fern test","description":"Fern test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92937","name":"Prq trluml revsc cab grf 1","description":"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed, single major coronary artery and/or its branches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":539.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28546","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28103","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29305","name":"Appl hip spica cast 1 leg","description":"Application of hip spica cast; 1 leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25272","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, single, each tendon or muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63170","name":"Incise spinal cord tract(s)","description":"Laminectomy with myelotomy (eg, bischof or drez type), cervical, thoracic, or thoracolumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3735.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28119","name":"Removal of heel spur","description":"Ostectomy, calcaneus; for spur, with or without plantar fascial release","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82800","name":"Blood ph","description":"Gases, blood, ph only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38207","name":"Cryopreserve stem cells","description":"Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","name":"Anes ther ivntl rad px icr","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4023.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84403","name":"Assay of total testosterone","description":"Testosterone; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67961","name":"Revision of eyelid","description":"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; up to one-fourth of lid margin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43202","name":"Esophagoscopy flex biopsy","description":"Esophagoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95717","name":"Eeg phys/qhp 2-12 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2-12 hours of eeg recording; without video","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7178.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33240","name":"Insrt pulse gen w/singl lead","description":"Insertion of implantable defibrillator pulse generator only; with existing single lead","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2842.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83970","name":"Assay of parathormone","description":"Parathormone (parathyroid hormone)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84525","name":"Urea nitrogen semi-quant","description":"Urea nitrogen; semiquantitative (eg, reagent strip test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8450.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42961","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64487","name":"Tap block uni by infusion","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35548","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21181","name":"Rcnst cntrg b9 tum crnl xtrc","description":"Reconstruction by contouring of benign tumor of cranial bones (eg, fibrous dysplasia), extracranial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27065","name":"Remove hip bone les super","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; superficial, includes autograft, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44180","name":"Lap enterolysis","description":"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93284","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous impla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36252","name":"Ins cath ren art 1st bilat","description":"Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and inte","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24530","name":"Cltx sprcndylr humeral fx wo","description":"Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31551","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, younger than 12 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1143.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95967","name":"Meg evoked each addl","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58353","name":"Endometr ablate thermal","description":"Endometrial ablation, thermal, without hysteroscopic guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36903","name":"Intro cath dialysis circuit","description":"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous out","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2565.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67121","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; intraocular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61322","name":"Crnec/crnot dcmprv w/o lobec","description":"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2179.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72149","name":"Mri lumbar spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64418","name":"Njx aa&/strd sprscap nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85366","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); paracoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62369","name":"Anal sp inf pmp w/reprg&fill","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27091","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1354.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58263","name":"Vag hyst w/t/o & vag repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93623","name":"Prgrmd stimj&pacg iv rx nfs","description":"Programmed stimulation and pacing after intravenous drug infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72084","name":"X-ray exam entire spi 6/> vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82252","name":"Fecal bilirubin test","description":"Bilirubin; feces, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1522.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27634","name":"Exc leg/ankle tum dep 5 cm/>","description":"Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58558","name":"Hysteroscopy biopsy","description":"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43335","name":"Transthor diaphrag hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64623","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70542","name":"Mri orbit/face/neck w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29040","name":"Appl bdy cst sho to hip head","description":"Application of body cast, shoulder to hips; including head, minerva type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24300","name":"Mnpj elbow under anes","description":"Manipulation, elbow, under anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45391","name":"Colonoscopy w/endoscope us","description":"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4341.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93544","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72157","name":"Mri chest spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5329.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0372","name":"Md service required for pmd","description":"Physician service required to establish and document the need for a power mobility device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35526","name":"Art byp grft aor/carot/innom","description":"Bypass graft, with vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1504.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2606.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0270","name":"Mnt subs tx for change dx","description":"Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","name":"Anes gastrocnemius recession","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10697.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44960","name":"Appendectomy","description":"Appendectomy; for ruptured appendix with abscess or generalized peritonitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63252","name":"Revise spine cord vsl thrlmb","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2801.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19112","name":"Excise breast duct fistula","description":"Excision of lactiferous duct fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28112","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; other metatarsal head (second, third or fourth)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24358","name":"Repair elbow w/deb open","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); debridement, soft tissue and/or bone, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39560","name":"Resect diaphragm simple","description":"Resection, diaphragm; with simple repair (eg, primary suture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73220","name":"Mri uppr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3909","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29840","name":"Wrist arthroscopy","description":"Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47720","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; direct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83021","name":"Hemoglobin chromotography","description":"Hemoglobin fractionation and quantitation; chromatography (eg, a2, s, c, and/or f)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83026","name":"Hemoglobin copper sulfate","description":"Hemoglobin; by copper sulfate method, non-automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3603.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63286","name":"Bx/exc idrl imed lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21246","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93268","name":"Ecg record/review","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; includes transmission, review and interpretation by a physician or other qualified hea","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33676","name":"Close mult vsd w/resection","description":"Closure of multiple ventricular septal defects; with pulmonary valvotomy or infundibular resection (acyanotic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1760.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95974","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90810","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","name":"Anes integ sys conv arrhyt","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87045","name":"Feces culture aerobic bact","description":"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, kia, lia), salmonella and shigella species","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19103","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15944","name":"Exc isch pr ulc skn flp clsr","description":"Excision, ischial pressure ulcer, with skin flap closure;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50686","name":"Measure ureter pressure","description":"Manometric studies through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0452","name":"Molecular pathology interpr","description":"Molecular pathology procedure; physician interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27140","name":"Transplant femur ridge","description":"Osteotomy and transfer of greater trochanter of femur (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27516","name":"Treat thigh fx growth plate","description":"Closed treatment of distal femoral epiphyseal separation; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35881","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with segmental vein interposition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":899.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93457","name":"R hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96376","name":"Tx/pro/dx inj same drug adon","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82693","name":"Assay of ethylene glycol","description":"Ethylene glycol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22865","name":"Rmvl tot arthrp 1ntrspc lmbr","description":"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2064.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30400","name":"Reconstruction of nose","description":"Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4199","name":"Parenteral sol > 100gm prote","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53405","name":"Revise urethra stage 2","description":"Urethroplasty; second stage (formation of urethra), including urinary diversion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84681","name":"Assay of c-peptide","description":"C-peptide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3995.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27097","name":"Revision of hip tendon","description":"Release or recession, hamstring, proximal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50434","name":"Convert nephrostomy catheter","description":"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27709","name":"Osteotomy tibia & fibula","description":"Osteotomy; tibia and fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3952.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78451","name":"Ht muscle image spect sing","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95961","name":"Electrode stimulation brain","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8697.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25605","name":"Cltx dst rdl fx/ephys sep w/","description":"Closed treatment of distal radial fracture (eg, colles or smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27181","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; osteotomy and internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":948.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89321","name":"Semen anal sperm detection","description":"Semen analysis; sperm presence and motility of sperm, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2855.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562T","name":"Antmc guide 3d print ea addl","description":"Anatomic guide 3d-printed and designed from image data set(s); each additional anatomic guide (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76506","name":"Echo exam of head","description":"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31645","name":"Brnchsc w/ther aspir 1st","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31200","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, anterior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57522","name":"Conization of cervix","description":"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64617","name":"Chemodener muscle larynx emg","description":"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15760","name":"Composite skin graft","description":"Graft; composite (eg, full thickness of external ear or nasal ala), including primary closure, donor area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5010","name":"Assessment for hearing aid","description":"Assessment for hearing aid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82379","name":"Assay of carnitine","description":"Carnitine (total and free), quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86806","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; without titration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37617","name":"Ligation major artery abd","description":"Ligation, major artery (eg, post-traumatic, rupture); abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64856","name":"Repair/transpose nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","name":"Anes opn/arthr tot sho rplcm","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22206","name":"Incis spine 3 column thorac","description":"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51060","name":"Removal of ureter stone","description":"Transvesical ureterolithotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24342","name":"Repair of ruptured tendon","description":"Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3142.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67840","name":"Remove eyelid lesion","description":"Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5454.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99498","name":"Advncd care plan addl 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (list separately in addition to code for primary proce","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27430","name":"Revision of thigh muscles","description":"Quadricepsplasty (eg, bennett or thompson type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22220","name":"Osteot dsc ant 1 vrt sgm crv","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0117","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69631","name":"Repair eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":713.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45563","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury; with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1385.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0008","name":"Admin influenza virus vac","description":"Administration of influenza virus vaccine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78481","name":"Heart first pass single","description":"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35583","name":"Vein byp grft fem-popliteal","description":"In-situ vein bypass; femoral-popliteal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88140","name":"Sex chromatin identification","description":"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50320","name":"Remove kidney living donor","description":"Donor nephrectomy (including cold preservation); open, from living donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86490","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84485","name":"Assay duodenal fluid trypsin","description":"Trypsin; duodenal fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97172","name":"Athletic trn re-eval plan cr","description":"Re-evaluation of athletic training established plan of care requiring these components: an assessment of patients current functional status when there is a documented change; and a revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54600","name":"Reduce testis torsion","description":"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37205","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4706.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43761","name":"Reposition gastrostomy tube","description":"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33858","name":"As-aort grf f/aortic dsj","description":"Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2964.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54535","name":"Extensive testis surgery","description":"Orchiectomy, radical, for tumor; with abdominal exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94770","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6239","name":"Hydrocolld drg > 48 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4040.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91013","name":"Esophgl motil w/stim/perfus","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","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, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82651","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45378","name":"Diagnostic colonoscopy","description":"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","53"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31294","name":"Nsl/sins ndsc surg on dcmprn","description":"Nasal/sinus endoscopy, surgical, with optic nerve decompression","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43340","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11463","name":"Exc skn hdrdnt ing complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52305","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73503","name":"X-ray exam hip uni 4/> views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63688","name":"Rev/rmv imp sp npg/r dtch cn","description":"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49507","name":"Prp i/hern init block >5 yr","description":"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65155","name":"Reinsert ocular implant","description":"Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61795","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8499","name":"Unlisted misc prosthetic ser","description":"Unlisted procedure for miscellaneous prosthetic services","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86638","name":"Q fever antibody","description":"Antibody; coxiella burnetii (q fever)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44120","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; single resection and anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43252","name":"Egd optical endomicroscopy","description":"Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93456","name":"R hrt coronary artery angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47537","name":"Removal biliary drg cath","description":"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86215","name":"Deoxyribonuclease antibody","description":"Deoxyribonuclease, antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01272","name":"Anes px art femoral art lig","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery ligation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86900","name":"Blood typing serologic abo","description":"Blood typing, serologic; abo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15201","name":"Fth/gft fr trnk each addl","description":"Full thickness graft, free, including direct closure of donor site, trunk; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93457","name":"R hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89130","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33954","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, 6 years and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42800","name":"Biopsy of throat","description":"Biopsy; oropharynx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61322","name":"Crnec/crnot dcmprv w/o lobec","description":"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2179.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93312","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0437","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97035","name":"App mdlty 1+ultrasound ea 15","description":"Application of a modality to 1 or more areas; ultrasound, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71021","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3672","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37209","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92995","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0168","name":"Wound closure by adhesive","description":"Wound closure utilizing tissue adhesive(s) only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3043.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43870","name":"Closure gastrostomy surgical","description":"Closure of gastrostomy, surgical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51500","name":"Removal of bladder cyst","description":"Excision of urachal cyst or sinus, with or without umbilical hernia repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27151","name":"Incision of hip bones","description":"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35642","name":"Bpg carotid-vertebral","description":"Bypass graft, with other than vein; carotid-vertebral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23615","name":"Optx prox humrl fx w/int fix","description":"Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11624","name":"Exc s/n/h/f/g mal+mrg 3.1-4","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88121","name":"Cytp urine 3-5 probes cmptr","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63610","name":"Stimulation of spinal cord","description":"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33920","name":"Repair pulmonary atresia","description":"Repair of pulmonary atresia with ventricular septal defect, by construction or replacement of conduit from right or left ventricle to pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96440","name":"Chmotx admn plrl cav thrcnts","description":"Chemotherapy administration into pleural cavity, requiring and including thoracentesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","name":"Anes px vn knee&pop av fstl","description":"Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2465.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":55.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88740","name":"Transcutaneous carboxyhb","description":"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86300","name":"Immunoassay tumor ca 15-3","description":"Immunoassay for tumor antigen, quantitative; ca 15-3 (27.29)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2003","name":"Post-d/c h vst new pt 45 m","description":"Moderate (45 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58660","name":"Laparoscopy lysis","description":"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29700","name":"Rmvl/bivlv gauntlet boot/cst","description":"Removal or bivalving; gauntlet, boot or body cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"Office o/p new sf 15 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceede","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31553","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, with indwelling stent placement, younger than 12 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87475","name":"Lyme dis dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia burgdorferi, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73220","name":"Mri uppr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3207","name":"Hightop w/ supp/pronator jun","description":"Orthopedic shoe, hightop with supinator or pronator, junior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23174","name":"Sqstrctmy humrl head srg nck","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to surgical neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32035","name":"Thoracostomy w/rib resection","description":"Thoracostomy; with rib resection for empyema","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72194","name":"Ct pelvis w/o & w/dye","description":"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31750","name":"Tracheoplasty cervical","description":"Tracheoplasty; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51797","name":"Intraabdominal pressure test","description":"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40510","name":"Partial excision of lip","description":"Excision of lip; transverse wedge excision with primary closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61640","name":"Dilate ic vasospasm init","description":"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86903","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559T","name":"Antmc mdl 3d print 1st cmpnt","description":"Anatomic model 3d-printed from image data set(s); first individually prepared and processed component of an anatomic structure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85303","name":"Clot inhibit prot c activity","description":"Clotting inhibitors or anticoagulants; protein c, activity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25931","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; re-amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27810","name":"Treatment of ankle fracture","description":"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83896","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01130","name":"Anes body cast appl/revj","description":"Anesthesia for body cast application or revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32560","name":"Treat pleurodesis w/agent","description":"Instillation, via chest tube/catheter, agent for pleurodesis (eg, talc for recurrent or persistent pneumothorax)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21127","name":"Augmentation mndblr b1 grf","description":"Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33952","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62351","name":"Implant spinal canal cath","description":"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81236","name":"Ezh2 gene full gene sequence","description":"Ezh2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53855","name":"Insert prost urethral stent","description":"Insertion of a temporary prostatic urethral stent, including urethral measurement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2528.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0078","name":"Care manag h vst new pt 45 m","description":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78223","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6086.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44705","name":"Prepare fecal microbiota","description":"Preparation of fecal microbiota for instillation, including assessment of donor specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":170.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56625","name":"Vulvectomy simple complete","description":"Vulvectomy simple; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49322","name":"Laparoscopy aspiration","description":"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5717.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27330","name":"Biopsy knee joint lining","description":"Arthrotomy, knee; with synovial biopsy only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69700","name":"Close mastoid fistula","description":"Closure postauricular fistula, mastoid (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21320","name":"Clsd tx nsl fx w/mnpj&stablj","description":"Closed treatment of nasal bone fracture with manipulation; with stabilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50727","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45392","name":"Colonoscopy w/endoscopic fnb","description":"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4554","name":"Disposable underpads","description":"Disposable underpads, all sizes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55862","name":"Extensive prostate surgery","description":"Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46080","name":"Sphnctrotmy anal div sphnctr","description":"Sphincterotomy, anal, division of sphincter (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57452","name":"Exam of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27816","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28455","name":"Tx tarsal b1 fx w/mnpj each","description":"Treatment of tarsal bone fracture (except talus and calcaneus); with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":95.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15941","name":"Exc isch pr ulc prm sut ostc","description":"Excision, ischial pressure ulcer, with primary suture; with ostectomy (ischiectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25907","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90681","name":"Rv1 vacc 2 dose live oral","description":"Rotavirus vaccine, human, attenuated (rv1), 2 dose schedule, live, for oral use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3044.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35092","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28039","name":"Exc foot/toe tum sc 1.5 cm/>","description":"Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24305","name":"Tendon lngth upr a/e ea tdn","description":"Tendon lengthening, upper arm or elbow, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86141","name":"C-reactive protein hs","description":"C-reactive protein; high sensitivity (hscrp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"Prev visit new age 40-64","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62351","name":"Implant spinal canal cath","description":"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2406.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65781","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44021","name":"Decompress small bowel","description":"Enterotomy, small intestine, other than duodenum; for decompression (eg, baker tube)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37618","name":"Ligation major artery xtr","description":"Ligation, major artery (eg, post-traumatic, rupture); extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93986","name":"Dup-scan hemo compl uni std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47001","name":"Ndl biopsy lvr tm oth maj px","description":"Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83026","name":"Hemoglobin copper sulfate","description":"Hemoglobin; by copper sulfate method, non-automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35266","name":"Rpr blvsl grf oth/th vn uxtr","description":"Repair blood vessel with graft other than vein; upper extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1009.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31510","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, indirect; with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33851","name":"Exc coa rpr l subcl art/prst","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; repair using either left subclavian artery or prosthetic material as gusset for enlargement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60271","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24130","name":"Excision radial head","description":"Excision, radial head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92585","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35646","name":"Bpg aortobifemoral","description":"Bypass graft, with other than vein; aortobifemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1511.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13122","name":"Cmplx rpr s/a/l addl 5 cm/>","description":"Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94776","name":"Ped home apnea mntr dl&alys","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; monitoring, download of information, receipt of transmission(s) and analyses by computer only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67121","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; intraocular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66990","name":"Ophthalmic endoscope add-on","description":"Use of ophthalmic endoscope (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85055","name":"Reticulated platelet assay","description":"Reticulated platelet assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72270","name":"Myelogphy 2/> spine regions","description":"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81173","name":"Ar gene full gene sequence","description":"Ar (androgen receptor) (eg, spinal and bulbar muscular atrophy, kennedy disease, x chromosome inactivation) gene analysis; full gene sequence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46230","name":"Removal of anal tags","description":"Excision of multiple external papillae or tags, anus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48152","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2430.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22864","name":"Rmvl tot arthrp 1ntrspc crv","description":"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14300","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33965","name":"Ecmo/ecls rmvl perph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80434","name":"Insulin tolerance panel","description":"Insulin tolerance panel; for acth insufficiency this panel must include the following: cortisol (82533 x 5) glucose (82947 x 5)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31766","name":"Carinal reconstruction","description":"Carinal reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1423.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80154","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3412.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82941","name":"Assay of gastrin","description":"Gastrin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2053.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84080","name":"Assay alkaline phosphatases","description":"Phosphatase, alkaline; isoenzymes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95885","name":"Musc tst done w/nerv tst lim","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95017","name":"All tstg perq&iq w/venoms","description":"Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with venoms, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82143","name":"Amniotic fluid scan","description":"Amniotic fluid scan (spectrophotometric)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1566.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3673","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54416","name":"Remv/repl penis contain pros","description":"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4726","name":"Dialys sol fld vol > 5999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42335","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), complicated, intraoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77048","name":"Mri breast c-+ w/cad uni","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92504","name":"Ear microscopy examination","description":"Binocular microscopy (separate diagnostic procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84830","name":"Ovulation tests","description":"Ovulation tests, by visual color comparison methods for human luteinizing hormone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27415","name":"Osteochondral knee allograft","description":"Osteochondral allograft, knee, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25690","name":"Cltx lunate dislc w/mnpj","description":"Closed treatment of lunate dislocation, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84439","name":"Assay of free thyroxine","description":"Thyroxine; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15940","name":"Exc ischial pr ulc prim sutr","description":"Excision, ischial pressure ulcer, with primary suture;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7917.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83518","name":"Immunoassay dipstick","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64868","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-hypoglossal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82787","name":"Igg 1 2 3 or 4 each","description":"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, igg1, 2, 3, or 4), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15005","name":"Wnd prep f/n/hf/g addl cm","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; each additional 100 sq cm, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93457","name":"R hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27445","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"Prev visit est age 12-17","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adole","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93460","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22328","name":"Treat each add spine fx","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebra or dislocated segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52000","name":"Cystourethroscopy","description":"Cystourethroscopy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72292","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0276","name":"Pild/placebo control clin tr","description":"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37215","name":"Transcath stent cca w/eps","description":"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28645","name":"Repair toe dislocation","description":"Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46706","name":"Repr of anal fistula w/glue","description":"Repair of anal fistula with fibrin glue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43847","name":"Gstr rstcv px sm int rcnstj","description":"Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7031.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5947.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27025","name":"Fasciotomy hip/thigh any typ","description":"Fasciotomy, hip or thigh, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64479","name":"Njx aa&/strd tfrm epi c/t 1","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), cervical or thoracic, single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77336","name":"Radiation physics consult","description":"Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47140","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments ii and iii)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29075","name":"Appl cst elbw fngr short arm","description":"Application, cast; elbow to finger (short arm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26568","name":"Lengthen metacarpal/finger","description":"Osteoplasty, lengthening, metacarpal or phalanx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84580","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; quantitative, timed specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41008","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85555","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; unincubated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63287","name":"Bx/exc idrl imed lesn thrlmb","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2526.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34705","name":"Evac rpr a-biiliac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1037.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1605.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36247","name":"Ins cath abd/l-ext art 3rd","description":"Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00561","name":"Anes px heart w/pump<1 yr","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32120","name":"Re-exploration of chest","description":"Thoracotomy; for postoperative complications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61151","name":"Burr hole/treph sbsq tapping","description":"Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62146","name":"Crnop w/autograft<5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5183.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52601","name":"Prostatectomy (turp)","description":"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24575","name":"Optx humeral epcndylr fx","description":"Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","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, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26852","name":"Fusion of knuckle with graft","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99454","name":"Rem mntr physiol param 16-30","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 16-30 days in a 30-day period","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69725","name":"Release facial nerve","description":"Decompression facial nerve, intratemporal; including medial to geniculate ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1517.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23802","name":"Arthrd glenohumeral jt w/grf","description":"Arthrodesis, glenohumeral joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32555","name":"Aspirate pleura w/ imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35390","name":"Reoperation carotid add-on","description":"Reoperation, carotid, thromboendarterectomy, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28272","name":"Release of toe joint each","description":"Capsulotomy; interphalangeal joint, each joint (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74183","name":"Mri abd w/o cntr flwd cntr","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61598","name":"Transpetrosal approach/skull","description":"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2588.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81275","name":"Kras gene variants exon 2","description":"Kras (kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92998","name":"Pul art balloon repr percut","description":"Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67112","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49180","name":"Biopsy abdominal mass","description":"Biopsy, abdominal or retroperitoneal mass, percutaneous needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41009","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31502","name":"Change of windpipe airway","description":"Tracheotomy tube change prior to establishment of fistula tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27509","name":"Treatment of thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, distal end, medial or lateral condyle, or supracondylar or transcondylar, with or without intercondylar extension, or distal femoral epiphyseal separation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86901","name":"Blood typing serologic rh(d)","description":"Blood typing, serologic; rh (d)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0217T","name":"Njx paravert w/us lumb/sac","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25392","name":"Shorten radius & ulna","description":"Osteoplasty, radius and ulna; shortening (excluding 64876)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":859.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4126.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01810","name":"Anes px nrv musc f/arm wrst","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51715","name":"Endoscopic injection/implant","description":"Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","name":"Anes clsd ch mediast&thrc w/","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58943","name":"Removal of ovary(s)","description":"Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments, with or without salpingectomy(s), with or without omentectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71060","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65105","name":"Remove eye/attach implant","description":"Enucleation of eye; with implant, muscles attached to implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A4397","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32672","name":"Thoracoscopy for lvrs","description":"Thoracoscopy, surgical; with resection-plication for emphysematous lung (bullous or non-bullous) for lung volume reduction (lvrs), unilateral includes any pleural procedure, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77413","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75946","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96365","name":"Ther/proph/diag iv inf init","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27613","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5233.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64627","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51992","name":"Laparo sling operation","description":"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507T","name":"Near ifr 2img mibmn glnd i&r","description":"Near infrared dual imaging (ie, simultaneous reflective and transilluminated light) of meibomian glands, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14621.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69636","name":"Rebuild eardrum structures","description":"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1115.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9685","name":"Acute nursing facility care","description":"Physician service or other qualified health care professional for the evaluation and management of a beneficiarys acute change in condition in a nursing facility. this service is for a demonstration project","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27310","name":"Exploration of knee joint","description":"Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64719","name":"Revise ulnar nerve at wrist","description":"Neuroplasty and/or transposition; ulnar nerve at wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33284","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23525","name":"Cltx strnclav dislc w/mnpj","description":"Closed treatment of sternoclavicular dislocation; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25350","name":"Revision of radius","description":"Osteotomy, radius; distal third","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30802","name":"Ablate inf turbinate submuc","description":"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (ie, submucosal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1441.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9141","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26450","name":"Incision of palm tendon","description":"Tenotomy, flexor, palm, open, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95852","name":"Range of motion measurements","description":"Range of motion measurements and report (separate procedure); hand, with or without comparison with normal side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","name":"Anes integ sys rad brst dsj","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67500","name":"Inject/treat eye socket","description":"Retrobulbar injection; medication (separate procedure, does not include supply of medication)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0245","name":"Initial foot exam pt lops","description":"Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3315.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68816","name":"Probe nl duct w/balloon","description":"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01850","name":"Anes vein f/arm wrst&hnd nos","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19302","name":"P-mastectomy w/ln removal","description":"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4105","name":"Enzyme cartridge enteral nut","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64912","name":"Nrv rpr w/nrv algrft 1st","description":"Nerve repair; with nerve allograft, each nerve, first strand (cable)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88368","name":"Insitu hybridization manual","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E8001","name":"Upright gait trainer","description":"Gait trainer, pediatric size, upright support, includes all accessories and components","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3822.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50705","name":"Ureteral embolization/occl","description":"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65205","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75558","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43886","name":"Gstr rstcv px opn revj port","description":"Gastric restrictive procedure, open; revision of subcutaneous port component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28050","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; intertarsal or tarsometatarsal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95936","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11001","name":"Dbrdmt ecz/infct skn ea addl","description":"Debridement of extensive eczematous or infected skin; each additional 10% of the body surface, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29877","name":"Arthrs knee surg dbrdmt/shvg","description":"Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23156","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50065","name":"Nl sec surg operj calculus","description":"Nephrolithotomy; secondary surgical operation for calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52346","name":"Cystouretero w/renal strict","description":"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43228","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96125","name":"Cognitive test by hc pro","description":"Standardized cognitive performance testing (eg, ross information processing assessment) per hour of a qualified health care professionals time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33264","name":"Rmvl & rplcmt dfb gen mlt ld","description":"Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01430","name":"Anes px veins knee&pop nos","description":"Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0296","name":"Visit to determ ldct elig","description":"Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28171","name":"Resect tarsal tumor","description":"Radical resection of tumor; tarsal (except talus or calcaneus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33050","name":"Resect heart sac lesion","description":"Resection of pericardial cyst or tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34051","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74330","name":"X-ray bile/panc endoscopy","description":"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90889","name":"Preparation of report","description":"Preparation of report of patients psychiatric status, history, treatment, or progress (other than for legal or consultative purposes) for other individuals, agencies, or insurance carriers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77049","name":"Mri breast c-+ w/cad bi","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87147","name":"Culture type immunologic","description":"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7266","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54401","name":"Insert self-contd prosthesis","description":"Insertion of penile prosthesis; inflatable (self-contained)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15786","name":"Abrasion lesion single","description":"Abrasion; single lesion (eg, keratosis, scar)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27566","name":"Treat kneecap dislocation","description":"Open treatment of patellar dislocation, with or without partial or total patellectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50020","name":"Drg perirnl/renal absc open","description":"Drainage of perirenal or renal abscess, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01484","name":"Anes opn lw l/a/f oste/ostpl","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44620","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21246","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95961","name":"Electrode stimulation brain","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34715","name":"Opn ax/subcla art expos","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"Immunization admin","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66840","name":"Removal of lens material","description":"Removal of lens material; aspiration technique, 1 or more stages","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66160","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3095.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69745","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92960","name":"Cardioversion electric ext","description":"Cardioversion, elective, electrical conversion of arrhythmia; external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33886","name":"Delayed plmt dstl xtn prosth","description":"Delayed placement of distal extension prosthesis(es) from the level of the left subclavian artery to the celiac artery, after endovascular repair of descending thoracic aorta, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological superv","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3450.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72141","name":"Mri neck spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0429","name":"Dermal filler injection(s)","description":"Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29916","name":"Hip arthro w/labral repair","description":"Arthroscopy, hip, surgical; with labral repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83051","name":"Hemoglobin plasma","description":"Hemoglobin; plasma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8505","name":"Artificial larynx, accessory","description":"Artificial larynx replacement battery / accessory, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4719","name":"Y set tubing","description":"Y set tubing for peritoneal dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61517","name":"Implt brn intrcv chemotx agt","description":"Implantation of brain intracavitary chemotherapy agent (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"Meas lung vol thru 2 yrs","description":"Measurement of lung volumes (ie, functional residual capacity [frc], forced vital capacity [fvc], and expiratory reserve volume [erv]) in an infant or child through 2 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50205","name":"Renal bx surg exposure kdn","description":"Renal biopsy; by surgical exposure of kidney","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90371","name":"Hep b ig im","description":"Hepatitis b immune globulin (hbig), human, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28062","name":"Removal of foot fascia","description":"Fasciectomy, plantar fascia; radical (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37140","name":"Revision of circulation","description":"Venous anastomosis, open; portocaval","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2045.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8220.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99151","name":"Mod sed same phys/qhp <5 yrs","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86677","name":"Helicobacter pylori antibody","description":"Antibody; helicobacter pylori","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94780","name":"Cars/bd tst inft-12mo 60 min","description":"Car seat/bed testing for airway integrity, for infants through 12 months of age, with continual clinical staff observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; 60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45505","name":"Repair of rectum","description":"Proctoplasty; for prolapse of mucous membrane","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"Psytx complex interactive","description":"Interactive complexity (list separately in addition to the code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61600","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1801.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4290","name":"Sacral nerve stim test lead","description":"Sacral nerve stimulation test lead, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54450","name":"Preputial stretching","description":"Foreskin manipulation including lysis of preputial adhesions and stretching","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45111","name":"Partial removal of rectum","description":"Proctectomy; partial resection of rectum, transabdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3252","name":"Shoe molded plastazote cust","description":"Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49560","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49013","name":"Prpertl pel pack hemrrg trma","description":"Preperitoneal pelvic packing for hemorrhage associated with pelvic trauma, including local exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29580","name":"Strapping unna boot","description":"Strapping; unna boot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49422","name":"Remove tunneled ip cath","description":"Removal of tunneled intraperitoneal catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93965","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92228","name":"Img rta detc/mntr ds phy/qhp","description":"Imaging of retina for detection or monitoring of disease; with remote physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33910","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2325.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62194","name":"Replace/irrigate catheter","description":"Replacement or irrigation, subarachnoid/subdural catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58960","name":"Exploration of abdomen","description":"Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diaphragmatic assessment with pelvic and limited para-aortic lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95921","name":"Autonomic nrv parasym inervj","description":"Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded r-r interval, valsalva ratio, and 30:15 ratio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4201.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63015","name":"Remove spine lamina >2 crvcl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33261","name":"Ablate heart dysrhythm focus","description":"Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35281","name":"Rpr blvsl gr ot/th vn ntr-ab","description":"Repair blood vessel with graft other than vein; intra-abdominal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31420","name":"Epiglottidectomy","description":"Epiglottidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01810","name":"Anes px nrv musc f/arm wrst","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17263","name":"Dstrj mal les t/a/l 2.1-3.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46601","name":"Diagnostic anoscopy","description":"Anoscopy; diagnostic, with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86717","name":"Leishmania antibody","description":"Antibody; leishmania","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97022","name":"Whirlpool therapy","description":"Application of a modality to 1 or more areas; whirlpool","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11839.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0128","name":"Corf skilled nursing service","description":"Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33726","name":"Repair pul venous stenosis","description":"Repair of pulmonary venous stenosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1768.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85384","name":"Fibrinogen activity","description":"Fibrinogen; activity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75954","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53510","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; perineal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","name":"Anes px nrv musc upr a&e nos","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32810","name":"Close chest after drainage","description":"Closure of chest wall following open flap drainage for empyema (clagett type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58290","name":"Vag hyst complex","description":"Vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64566","name":"Neuroeltrd stim post tibial","description":"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92240","name":"Icg angiography i&r uni/bi","description":"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66985","name":"Insert lens prosthesis","description":"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["AW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","name":"Anes clsd px shoulder joint","description":"Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27405","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; collateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87283","name":"Rubeola ag if","description":"Infectious agent antigen detection by immunofluorescent technique; rubeola","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62223","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":935.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93294","name":"Rem interrog evl pm/ldls pm","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, or leadless pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5609.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76885","name":"Us exam infant hips dynamic","description":"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50391","name":"Instll rx agnt into rnal tub","description":"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4524","name":"Adult size brief/diaper xl","description":"Adult sized disposable incontinence product, brief/diaper, extra large, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36481","name":"Insertion of catheter vein","description":"Percutaneous portal vein catheterization by any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93454","name":"Coronary artery angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479T","name":"Fxjl abl lsr 1st 100 sq cm","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof, or 1% of body surface area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2587.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2339.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3221","name":"Orthopedic mens shoes dpth i","description":"Orthopedic footwear, mens shoe, depth inlay, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92082","name":"Intermediate visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on goldmann perimeter, or semiquantitative, automated suprathreshold screening program, humphrey suprathreshold automatic diagnostic test, octopus program 33)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95705","name":"Eeg w/o vid 2-12 hr unmntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, 2-12 hours; unmonitored","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77300","name":"Radiation therapy dose plan","description":"Basic radiation dosimetry calculation, central axis depth dose calculation, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92984","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","name":"Anes px vn knee&pop av fstl","description":"Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32550","name":"Insert pleural cath","description":"Insertion of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22818","name":"Kyphectomy 1-2 segments","description":"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); single or 2 segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14041","name":"Tis trnfr f/c/c/m/n/a/g/h/f","description":"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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 (","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2625.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45378","name":"Diagnostic colonoscopy","description":"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35683","name":"Composite byp grft 3/> segmt","description":"Bypass graft; autogenous composite, 3 or more segments of vein from 2 or more locations (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84203","name":"Test rbc protoporphyrin","description":"Protoporphyrin, rbc; screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37609","name":"Ligation/bx temporal artery","description":"Ligation or biopsy, temporal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31573","name":"Largsc w/ther injection","description":"Laryngoscopy, flexible; with therapeutic injection(s) (eg, chemodenervation agent or corticosteroid, injected percutaneous, transoral, or via endoscope channel), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31786","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52441","name":"Cysto insj trnsprstc 1 implt","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23550","name":"Optx acromclv dislc aqt/chrn","description":"Open treatment of acromioclavicular dislocation, acute or chronic;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83902","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67830","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84182","name":"Protein western blot test","description":"Protein; western blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93455","name":"Coronary art/grft angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3208","name":"Surgical boot each infant","description":"Surgical boot, each, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71555","name":"Mri angio chest w or w/o dye","description":"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56632","name":"Vlvctmy rad prtl bi lymphad","description":"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0150T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93461","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, cath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92285","name":"External ocular photography","description":"External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39421.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6017","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61333","name":"Expl orbit w/removal lesion","description":"Exploration of orbit (transcranial approach), with removal of lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27681","name":"Release of lower leg tendons","description":"Tenolysis, flexor or extensor tendon, leg and/or ankle; multiple tendons (through separate incision[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84285","name":"Assay of silica","description":"Silica","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64870","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64420","name":"Njx aa&/strd ntrcost nrv 1","description":"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57020","name":"Colpocentesis sep px","description":"Colpocentesis (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51595","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27535","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66920","name":"Extraction of lens","description":"Removal of lens material; intracapsular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68040","name":"Treatment of eyelid lesions","description":"Expression of conjunctival follicles (eg, for trachoma)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62267","name":"Interdiscal perq aspir dx","description":"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19020","name":"Mastotomy expl drg absc dp","description":"Mastotomy with exploration or drainage of abscess, deep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44227","name":"Lap close enterostomy","description":"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1372.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78801","name":"Rp loclzj tum 2+area 1+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or m","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40019.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37780","name":"Revision of leg vein","description":"Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11404","name":"Exc tr-ext b9+marg 3.1-4 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2114.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0317","name":"Prolong nursin fac eval 15m","description":"Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92273","name":"Full field erg w/i&r","description":"Electroretinography (erg), with interpretation and report; full field (ie, fferg, flash erg, ganzfeld erg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67343","name":"Release eye tissue","description":"Release of extensive scar tissue without detaching extraocular muscle (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54415","name":"Remove self-contd penis pros","description":"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93289","name":"Interrog device eval heart","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including anal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49568","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01931","name":"Anes ivnt rad ntrhpt/prt crc","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrahepatic or portal circulation (eg, transvenous intrahepatic portosystemic shunt[s] [tips])","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87400","name":"Influenza a/b each ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; influenza, a or b, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86816","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, single antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92572","name":"Staggered spondaic word test","description":"Staggered spondaic word test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25695","name":"Optx lunate dislocation","description":"Open treatment of lunate dislocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95938","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74240","name":"X-ray xm upr gi trc 1cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15297.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34843","name":"Endovasc visc aorta 3 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1394.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50390","name":"Drainage of kidney lesion","description":"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83586","name":"Assay 17- ketosteroids","description":"Ketosteroids, 17- (17-ks); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3365.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8644.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4554.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","name":"Anes open total ankle rplcmt","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82397","name":"Chemiluminescent assay","description":"Chemiluminescent assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","name":"Tumor immunohistochem/manual","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34715","name":"Opn ax/subcla art expos","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33365","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89220","name":"Sputum specimen collection","description":"Sputum, obtaining specimen, aerosol induced technique (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35045","name":"Repair defect of arm artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, radial or ulnar artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94003","name":"Vent mgmt inpat subq day","description":"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, each subsequent day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2525.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49582","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99231","name":"Sbsq hosp ip/obs sf/low 25","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selec","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27745","name":"Reinforce tibia","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, tibia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505T","name":"Ev fempop artl revsc","description":"Endovenous femoral-popliteal arterial revascularization, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultrasound guidance for vascular access when performed, all catheterization(s) and intraprocedural roadmapp","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2321.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73222","name":"Mri joint upr extrem w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20101","name":"Expl pentrg wound chest","description":"Exploration of penetrating wound (separate procedure); chest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2244.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82370","name":"X-ray assay calculus","description":"Calculus; x-ray diffraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4500","name":"Below knee surgical stocking","description":"Surgical stockings below knee length, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4810.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47533","name":"Plmt biliary drainage cath","description":"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6558.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51925","name":"Hysterectomy/bladder repair","description":"Closure of vesicouterine fistula; with hysterectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","name":"Anes male gent rad orch ing","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59001","name":"Amniocentesis therapeutic","description":"Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96375","name":"Tx/pro/dx inj new drug addon","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61783","name":"Scan proc spinal","description":"Stereotactic computer-assisted (navigational) procedure; spinal (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28046","name":"Resect foot/toe tumor < 3 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53444","name":"Insert tandem cuff","description":"Insertion of tandem cuff (dual cuff)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97803","name":"Med nutrition indiv subseq","description":"Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22804","name":"Arthrd pst dfrm 13+ vrt sgm","description":"Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2116.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92950","name":"Heart/lung resuscitation cpr","description":"Cardiopulmonary resuscitation (eg, in cardiac arrest)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67320","name":"Revise eye muscle(s) add-on","description":"Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30310","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; requiring general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1255.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84479","name":"Assay of thyroid (t3 or t4)","description":"Thyroid hormone (t3 or t4) uptake or thyroid hormone binding ratio (thbr)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24102","name":"Arthrt elbow w/synovectomy","description":"Arthrotomy, elbow; with synovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4040.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27200","name":"Treat tail bone fracture","description":"Closed treatment of coccygeal fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70488","name":"Ct maxillofacial w/o & w/dye","description":"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90901","name":"Biofeedback train any meth","description":"Biofeedback training by any modality","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67332","name":"Rerevise eye muscles add-on","description":"Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27822","name":"Treatment of ankle fracture","description":"Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; without fixation of posterior lip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99185","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2114.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36819","name":"Av fuse uppr arm basilic","description":"Arteriovenous anastomosis, open; by upper arm basilic vein transposition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","name":"Anes thrc spine wo 1lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95984","name":"Alys brn npgt prgrmg addl 15","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45390","name":"Colonoscopy w/resection","description":"Colonoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59870","name":"Evacuate mole of uterus","description":"Uterine evacuation and curettage for hydatidiform mole","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93965","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88280","name":"Chromosome karyotype study","description":"Chromosome analysis; additional karyotypes, each study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75571","name":"Ct hrt w/o dye w/ca test","description":"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53450","name":"Revision of urethra","description":"Urethromeatoplasty, with mucosal advancement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47511","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28585","name":"Repair foot dislocation","description":"Open treatment of talotarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87555","name":"M.tuberculo dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20500","name":"Njx sinus tract therapeutic","description":"Injection of sinus tract; therapeutic (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31622","name":"Dx bronchoscope/wash","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64624","name":"Dstrj nulyt agt gnclr nrv","description":"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49325","name":"Lap revision perm ip cath","description":"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53446","name":"Remove uro sphincter","description":"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87798","name":"Detect agent nos dna amp","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; amplified probe technique, each organism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62322","name":"Njx interlaminar lmbr/sac","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3999","name":"Upper limb orthosis nos","description":"Upper limb orthosis, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21348","name":"Opn tx nasomax fx w/graft","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); with bone grafting (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62117","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1801.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21084","name":"Impres&prep sp aid prosth","description":"Impression and custom preparation; speech aid prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24535","name":"Cltx sprcndylr humeral fx w/","description":"Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32540","name":"Removal of lung lesion","description":"Extrapleural enucleation of empyema (empyemectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1385.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82595","name":"Assay of cryoglobulin","description":"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45341","name":"Sigmoidoscopy w/ultrasound","description":"Sigmoidoscopy, flexible; with endoscopic ultrasound examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92597","name":"Oral speech device eval","description":"Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4212","name":"Non coring needle or stylet","description":"Non-coring needle or stylet with or without catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83009","name":"H pylori (c-13) blood","description":"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0438","name":"Ppps, initial visit","description":"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35876","name":"Removal of clot in graft","description":"Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); with revision of arterial or venous graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49325","name":"Lap revision perm ip cath","description":"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86357","name":"Nk cells total count","description":"Natural killer (nk) cells, total count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44187","name":"Lap ileo/jejuno-stomy","description":"Laparoscopy, surgical; ileostomy or jejunostomy, non-tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4614.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31241","name":"Nsl/sns ndsc lig sphnptn art","description":"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28126","name":"Partial removal of toe","description":"Resection, partial or complete, phalangeal base, each toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78593","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33227","name":"Remove&replace pm gen singl","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25420","name":"Repair/graft radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72159","name":"Mr angio spine w/o&w/dye","description":"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4154","name":"Ef spec metabolic noninherit","description":"Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0108","name":"Diab manage trn per indiv","description":"Diabetes outpatient self-management training services, individual, per 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2252","name":"Brief chkin by md/qhp, 11-20","description":"Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor le","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67229","name":"Tr retinal les preterm inf","description":"Treatment of extensive or progressive retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1 year of age (eg, retinopathy of prematurity), photocoagulation or cryotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":26.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93287","name":"Peri-px device eval & prgr","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56800","name":"Plastic repair introitus","description":"Plastic repair of introitus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1992.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27165","name":"Incision/fixation of femur","description":"Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11623","name":"Exc s/n/h/f/g mal+mrg 2.1-3","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46505","name":"Chemodenervation anal musc","description":"Chemodenervation of internal anal sphincter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95004","name":"Perq tests w/alrgnc xtrcs","description":"Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58546","name":"Laparo-myomectomy complex","description":"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68530","name":"Clearance of tear duct","description":"Removal of foreign body or dacryolith, lacrimal passages","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52649","name":"Prostate laser enucleation","description":"Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94660","name":"Cpap initiation&mgmt","description":"Continuous positive airway pressure ventilation (cpap), initiation and management","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28240","name":"Release of big toe","description":"Tenotomy, lengthening, or release, abductor hallucis muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54326","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81271","name":"Htt gene detc abnor alleles","description":"Htt (huntingtin) (eg, huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85045","name":"Automated reticulocyte count","description":"Blood count; reticulocyte, automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","name":"Anes px ear w/bx nos","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56420","name":"I&d bartholins gland abscess","description":"Incision and drainage of bartholins gland abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53235","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); male","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","name":"Anes dx/ther nrv blk&inj oth","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43324","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11719","name":"Trim nail(s) any number","description":"Trimming of nondystrophic nails, any number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64490","name":"Inj paravert f jnt c/t 1 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3744.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":7107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82485","name":"Assay chondroitin sulfate","description":"Chondroitin b sulfate, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88289","name":"Chromosome study additional","description":"Chromosome analysis; additional high resolution study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67966","name":"Revision of eyelid","description":"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; over one-fourth of lid margin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92995","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0127","name":"Trim nail(s)","description":"Trimming of dystrophic nails, any number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9044","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93798","name":"Phys/qhp op car rhab w/ecg","description":"Physician or other qualified health care professional services for outpatient cardiac rehabilitation; with continuous ecg monitoring (per session)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91110","name":"Gi trc img intral esoph-ile","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26608","name":"Treat metacarpal fracture","description":"Percutaneous skeletal fixation of metacarpal fracture, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85360","name":"Euglobulin lysis","description":"Euglobulin lysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61635","name":"Intracran angioplsty w/stent","description":"Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1263.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0010","name":"Admin hepatitis b vaccine","description":"Administration of hepatitis b vaccine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25525","name":"Optx rdl shft fx&cltx rad/ul","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed, and closed treatment of distal radioulnar joint dislocation (galeazzi fracture/ dislocation), includes percutaneous skeletal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78452","name":"Ht muscle image spect mult","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or red","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51727","name":"Cystometrogram w/up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43611","name":"Excision of stomach lesion","description":"Excision, local; malignant tumor of stomach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43840","name":"Gstrrphy sutr duol/gstr ulcr","description":"Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1136.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47140","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments ii and iii)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69501","name":"Mastoidectomy","description":"Transmastoid antrotomy (simple mastoidectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63051","name":"C-laminoplasty w/graft/plate","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0423","name":"Intens cardiac rehab no exer","description":"Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54410","name":"Remove/replace penis prosth","description":"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4376.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93662","name":"Intracardiac ecg (ice)","description":"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"Office o/p est sf 10 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0399","name":"Home sleep test/type 3 porta","description":"Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","name":"Anes art sho&ax ax-fem bpg","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90945","name":"Dialysis one evaluation","description":"Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies), with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82530","name":"Cortisol free","description":"Cortisol; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42160","name":"Treatment mouth roof lesion","description":"Destruction of lesion, palate or uvula (thermal, cryo or chemical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1548.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4947.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36466","name":"Njx noncmpnd sclrsnt mlt vn","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93314","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5069.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26756","name":"Pin finger fracture each","description":"Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41114","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; with local tongue flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89132","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93284","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous impla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KC","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48155","name":"Removal of pancreas","description":"Pancreatectomy, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1509.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90465","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41872","name":"Gingivoplasty each quadrant","description":"Gingivoplasty, each quadrant (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85290","name":"Clot factor xiii fibrin stab","description":"Clotting; factor xiii (fibrin stabilizing)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38740","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50974","name":"Ureter endoscopy & biopsy","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61692","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3392.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62225","name":"Replace/irrigate catheter","description":"Replacement or irrigation, ventricular catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89230","name":"Collect sweat for test","description":"Sweat collection by iontophoresis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26025","name":"Drainage of palm bursa","description":"Drainage of palmar bursa; single, bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87045","name":"Feces culture aerobic bact","description":"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, kia, lia), salmonella and shigella species","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86664","name":"Epstein-barr nuclear antigen","description":"Antibody; epstein-barr (eb) virus, nuclear antigen (ebna)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94070","name":"Evaluation of wheezing","description":"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00326","name":"Anes all px larynx&trach<1yr","description":"Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48100","name":"Biopsy of pancreas open","description":"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35539","name":"Art byp grft aortofemoral","description":"Bypass graft, with vein; aortofemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1942.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35331","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; abdominal aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93236","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27380","name":"Repair of kneecap tendon","description":"Suture of infrapatellar tendon; primary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46050","name":"I&d perianal abscess supfc","description":"Incision and drainage, perianal abscess, superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70470","name":"Ct head/brain w/o & w/dye","description":"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86320","name":"Serum immunoelectrophoresis","description":"Immunoelectrophoresis; serum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0399","name":"Home sleep test/type 3 porta","description":"Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29065","name":"Appl cst sho to hand lng arm","description":"Application, cast; shoulder to hand (long arm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95920","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15261","name":"Fth/gft fr n/e/e/l each addl","description":"Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82154","name":"Androstanediol glucuronide","description":"Androstanediol glucuronide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19301","name":"Partial mastectomy","description":"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93571","name":"Iv dop vel&/press c flo 1st","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; initial vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87253","name":"Virus inoculate tissue addl","description":"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21338","name":"Open nasoethmoid fx w/o fixj","description":"Open treatment of nasoethmoid fracture; without external fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33933","name":"Prepare donor heart/lung","description":"Backbench standard preparation of cadaver donor heart/lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, and trachea for implantation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97110","name":"Therapeutic exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35221","name":"Rpr bld vsl dir intra-abdl","description":"Repair blood vessel, direct; intra-abdominal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1284.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2808.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43850","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3253","name":"Shoe molded plastazote cust","description":"Foot, molded shoe plastazote (or similar) custom fitted, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83913","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99252","name":"Ip/obs consltj new/est sf 35","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15953","name":"Exc trchntr pr ulc flp ostc","description":"Excision, trochanteric pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84134","name":"Assay of prealbumin","description":"Prealbumin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23125","name":"Claviculectomy total","description":"Claviculectomy; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64859","name":"Nerve surgery","description":"Suture of each additional major peripheral nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11463","name":"Exc skn hdrdnt ing complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57530","name":"Removal of cervix","description":"Trachelectomy (cervicectomy), amputation of cervix (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99364","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","name":"Anes integ sys rcnstv breast","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27236","name":"Treat thigh fracture","description":"Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72141","name":"Mri neck spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81179","name":"Atxn2 gene detc abnor allele","description":"Atxn2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62368","name":"Analyze sp inf pump w/reprog","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96401","name":"Chemo anti-neopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62223","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":935.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67550","name":"Insert eye socket implant","description":"Orbital implant (implant outside muscle cone); insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8476.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5307.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93721","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33883","name":"Delayed plmt prox xtn prosth","description":"Delayed placement of proximal extension prosthesis(es) not involving coverage of the left subclavian artery origin, after endovascular repair of the thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and inter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21490","name":"Optx tmprmand dislocation","description":"Open treatment of temporomandibular dislocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35022","name":"Repair artery rupture chest","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, innominate, subclavian artery, by thoracic incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1248.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57289","name":"Repair bladder & vagina","description":"Pereyra procedure, including anterior colporrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55680","name":"Remove sperm pouch lesion","description":"Excision of mullerian duct cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92633","name":"Aud rehab postling hear loss","description":"Auditory rehabilitation; postlingual hearing loss","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26125","name":"Release palm contracture","description":"Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft); each additional digit (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93533","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1742.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84702","name":"Chorionic gonadotropin test","description":"Gonadotropin, chorionic (hcg); quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0498","name":"Chemo extend iv infus w/pump","description":"Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27177","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; single or multiple pinning or bone graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11426","name":"Exc h-f-nk-sp b9+marg >4 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21026","name":"Excision of facial bone(s)","description":"Excision of bone (eg, for osteomyelitis or bone abscess); facial bone(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67715","name":"Canthotomy","description":"Canthotomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92310","name":"Contact lens fitting ou","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens, both eyes, except for aphakia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43337","name":"Thorabd diaphr hern repair","description":"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; with implantation of mesh or other prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1284.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28173","name":"Resect metatarsal tumor","description":"Radical resection of tumor; metatarsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25246","name":"Injection for wrist x-ray","description":"Injection procedure for wrist arthrography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99308","name":"Sbsq nf care low mdm 20","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exce","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8879.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63170","name":"Incise spinal cord tract(s)","description":"Laminectomy with myelotomy (eg, bischof or drez type), cervical, thoracic, or thoracolumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP22","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27659","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22632","name":"Arthrd pst tq 1ntrspc lm ea","description":"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97608","name":"Neg prs wnd ther ndme>50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01758","name":"Anes opn/arthrs elbw exc cst","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; excision of cyst or tumor of humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21365","name":"Opn tx complx malar fx","description":"Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with internal fixation and multiple surgical approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP06","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51880","name":"Repair of bladder opening","description":"Closure of cystostomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90889","name":"Preparation of report","description":"Preparation of report of patients psychiatric status, history, treatment, or progress (other than for legal or consultative purposes) for other individuals, agencies, or insurance carriers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3544.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31535","name":"Laryngoscopy w/biopsy","description":"Laryngoscopy, direct, operative, with biopsy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44186","name":"Lap jejunostomy","description":"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46020","name":"Placement of seton","description":"Placement of seton","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44055","name":"Correct malrotation of bowel","description":"Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (eg, ladd procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55874","name":"Tprnl plmt biodegrdabl matrl","description":"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2475.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15200","name":"Fth/gft fr trnk 20 sq cm/<","description":"Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61120","name":"Burr hole for ventr puncture","description":"Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4178","name":"Parenteral sol amino acid >","description":"Parenteral nutrition solution: amino acid, greater than 8.5% (500 ml = 1 unit) - home mix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4231","name":"Infusion insulin pump needle","description":"Infusion set for external insulin pump, needle type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01610","name":"Anes all px nrv musc sho&ax","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49324","name":"Lap insert tunnel ip cath","description":"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15936","name":"Exc sac pr ulc prep mus flap","description":"Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3701","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43460","name":"Pressure treatment esophagus","description":"Esophagogastric tamponade, with balloon (sengstaken type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11313","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44360","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35633","name":"Bpg ilio-mesenteric","description":"Bypass graft, with other than vein; ilio-mesenteric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28465","name":"Optx tarsal bone fx each","description":"Open treatment of tarsal bone fracture (except talus and calcaneus), includes internal fixation, when performed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86654","name":"Encephaltis west eqne antbdy","description":"Antibody; encephalitis, western equine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28890","name":"Hi enrgy eswt plantar fascia","description":"Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87582","name":"M.pneumon dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63011","name":"Remove spine lamina 1/2 scrl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61460","name":"Crnec sopl sctj 1+crnl nrv","description":"Craniectomy, suboccipital; for section of 1 or more cranial nerves","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1930.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21330","name":"Open tx nose fx w/skele fixj","description":"Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4252","name":"Blood ketone test or strip","description":"Blood ketone test or reagent strip, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87590","name":"N.gonorrhoeae dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518T","name":"Rmvl pg wcs lv battery only","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; battery component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27076","name":"Resect hip tum incl acetabul","description":"Radical resection of tumor; ilium, including acetabulum, both pubic rami, or ischium and acetabulum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43458","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49566","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36908","name":"Stent plmt ctr dialysis seg","description":"Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment (list separately in addition to","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61458","name":"Crnec sopl xpl/dcmpr crl nrv","description":"Craniectomy, suboccipital; for exploration or decompression of cranial nerves","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1839.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93226","name":"Xtrnl ecg rec<48 hr scan a/r","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33997","name":"Rmvl perq right heart vad","description":"Removal of percutaneous right heart ventricular assist device, venous cannula, at separate and distinct session from insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11046","name":"Dbrdmt musc&/fsca ea addl","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25105","name":"Remove wrist joint lining","description":"Arthrotomy, wrist joint; with synovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54100","name":"Biopsy of penis","description":"Biopsy of penis; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86343","name":"Leukocyte histamine release","description":"Leukocyte histamine release test (lhr)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP16","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95950","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31293","name":"Nsl/sins ndsc med&inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial and inferior wall","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35151","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, popliteal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1089.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38571","name":"Laparoscopy lymphadenectomy","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19082","name":"Bx breast add lesion strtctc","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including stereotactic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25170","name":"Resect radius/ulnar tumor","description":"Radical resection of tumor, radius or ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1605.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75572","name":"Ct hrt w/3d image","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4932","name":"Reusable rectal thermometer","description":"Rectal thermometer, reusable, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2065","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26540","name":"Repair hand joint","description":"Repair of collateral ligament, metacarpophalangeal or interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26580","name":"Repair cleft hand","description":"Repair cleft hand","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29820","name":"Sho arthrs srg prtl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93283","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantab","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64622","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76937","name":"Us guide vascular access","description":"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97167","name":"Ot eval high complex 60 min","description":"Occupational therapy evaluation, high complexity, requiring these components: an occupational profile and medical and therapy history, which includes review of medical and/or therapy records and extensive additional review of physical, cognitive, or psychosocial history related to current functional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43264","name":"Ercp remove duct calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of calculi/debris from biliary/pancreatic duct(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28102","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27501","name":"Treatment of thigh fracture","description":"Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31276","name":"Nsl/sins ndsc frnt tiss rmvl","description":"Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95131","name":"Immntx 2 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 2 stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49652","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42860","name":"Excision of tonsil tags","description":"Excision of tonsil tags","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61651","name":"Evasc prlng admn rx agnt add","description":"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each additional vascular territory (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","name":"Anes px fcl b1/skl rad surg","description":"Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36478","name":"Endovenous laser 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56820","name":"Colposcopy vulva","description":"Colposcopy of the vulva;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61524","name":"Removal of brain lesion","description":"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43116","name":"Partial removal of esophagus","description":"Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4180.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31298","name":"Nsl/sins ndsc surg frnt&sphn","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2683.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47535","name":"Conversion ext bil drg cath","description":"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0296","name":"Visit to determ ldct elig","description":"Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0184T","name":"Exc rectal tumor endoscopic","description":"Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, tems), including muscularis propria (ie, full thickness)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94452","name":"Hast w/i&r phys/qhp","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69667","name":"Repair middle ear structures","description":"Repair round window fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0144","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82370","name":"X-ray assay calculus","description":"Calculus; x-ray diffraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85611","name":"Prothrombin test","description":"Prothrombin time; substitution, plasma fractions, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67115","name":"Release encircling material","description":"Release of encircling material (posterior segment)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50693","name":"Plmt ureteral stent prq","description":"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; pre-existing nephrostomy tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71035","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15050","name":"Pinch graft up to 2 cm diam","description":"Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86816","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, single antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10036","name":"Plmt sft tiss loclzj dev ea","description":"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1470.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"Esrd svc pr day pt 20+","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 20 years of age and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63001","name":"Remove spine lamina 1/2 crvl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5241","name":"Dispensing fee, monaural","description":"Dispensing fee, monaural hearing aid, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","name":"Anes maj lwr adb vsl ivc lig","description":"Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85475","name":"Hemolysin acid","description":"Hemolysin, acid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95148","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 4 single stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83582","name":"Assay of ketogenic steroids","description":"Ketogenic steroids, fractionation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47370","name":"Laparo ablate liver tumor rf","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","name":"Anes vaginal px nos","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95806","name":"Sleep study unatt&resp efft","description":"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274T","name":"Prq lamot/lam dcmpr crv/thrc","description":"Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, under indirect image guidance (eg, fluoroscopic, ct), single or multiple levels, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45172","name":"Exc rect tum transanal full","description":"Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1998.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2142.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19120","name":"Removal of breast lesion","description":"Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0507","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11920","name":"Correct skin color 6.0 cm/<","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.0 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21925","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; deep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55860","name":"Surgical exposure prostate","description":"Exposure of prostate, any approach, for insertion of radioactive substance;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76942","name":"Echo guide for biopsy","description":"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58750","name":"Repair oviduct","description":"Tubotubal anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21450","name":"Cltx mndblr fx w/o mnpj","description":"Closed treatment of mandibular fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64821","name":"Sympathectomy radial artery","description":"Sympathectomy; radial artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70482","name":"Ct orbit/ear/fossa w/o&w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1553.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3619.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38570","name":"Laparoscopy lymph node biop","description":"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57421","name":"Exam/biopsy of vag w/scope","description":"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27396","name":"Transplant of thigh tendon","description":"Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8908","name":"Mri w/o fol w/cont, breast,","description":"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42508","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42550","name":"Injection for salivary x-ray","description":"Injection procedure for sialography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54235","name":"Njx corpora cavernosa rx agt","description":"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9275","name":"Disp home glucose monitor","description":"Home glucose disposable monitor, includes test strips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78831","name":"Rp loclzj tum spect 2 areas","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76814","name":"Ob us nuchal meas add-on","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62320","name":"Njx interlaminar crv/thrc","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67405","name":"Explore/drain eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87556","name":"M.tuberculo dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64450","name":"Njx aa&/strd other pn/branch","description":"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4680.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61526","name":"Removal of brain lesion","description":"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2950.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96160","name":"Pt-focused hlth risk assmt","description":"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument","date_of_service":"2026-09-01","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95","ET","CR"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95","ET","CR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95","ET","CR"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95","ET","CR"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95","ET","CR"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95","ET","CR"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95","ET","CR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27305","name":"Incise thigh tendon & fascia","description":"Fasciotomy, iliotibial (tenotomy), open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97168","name":"Ot re-eval est plan care","description":"Re-evaluation of occupational therapy established plan of care, requiring these components: an assessment of changes in patient functional or medical status with revised plan of care; an update to the initial occupational profile to reflect changes in condition or environment that affect future inte","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93508","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46700","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; adult","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10160","name":"Pnxr aspir absc hmtma bulla","description":"Puncture aspiration of abscess, hematoma, bulla, or cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95805","name":"Multiple sleep latency test","description":"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15834","name":"Exc excessive skin hip","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95925","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43259","name":"Egd us exam duodenum/jejunum","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"Off/op cnsltj new/est low 30","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1305.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35601","name":"Bpg com crtd-ipsi int crtd","description":"Bypass graft, with other than vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1233.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33019","name":"Perq prcrd drg insj cath ct","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including ct guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58605","name":"Division of fallopian tube","description":"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53502","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury, female","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45120","name":"Removal of rectum","description":"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull-through procedure and anastomosis (eg, swenson, duhamel, or soave type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","name":"Anes ther ivntl rad artl nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92260","name":"Ophthalmodynamometry","description":"Ophthalmodynamometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33980","name":"Remove intracorporeal device","description":"Removal of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1549.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69552","name":"Exc aurl glomus tum trnsmstd","description":"Excision aural glomus tumor; transmastoid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57311","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula; with bulbocavernosus transplant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99186","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93592","name":"Perq transcath closure each","description":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69705","name":"Nps surg dilat eust tube uni","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27830","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21263","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1904.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","name":"Anes insj penile prosthesis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26497","name":"Finger tendon transfer","description":"Transfer of tendon to restore intrinsic function; ring and small finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75893","name":"Venous sampling by catheter","description":"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]},{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20975","name":"Estim aid bone healg invasiv","description":"Electrical stimulation to aid bone healing; invasive (operative)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73706","name":"Ct angio lwr extr w/o&w/dye","description":"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87255","name":"Genet virus isolate hsv","description":"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37606","name":"Lig int/com carotid art occl","description":"Ligation; internal or common carotid artery, with gradual occlusion, as with selverstone or crutchfield clamp","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36012","name":"Place catheter in vein","description":"Selective catheter placement, venous system; second order, or more selective, branch (eg, left adrenal vein, petrosal sinus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1501.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11462","name":"Exc skn hdrdnt ing smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or intermediate repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44720","name":"Prep donor intestine/venous","description":"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; venous anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99468","name":"Neonate crit care initial","description":"Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35475","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507T","name":"Near ifr 2img mibmn glnd i&r","description":"Near infrared dual imaging (ie, simultaneous reflective and transilluminated light) of meibomian glands, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67912","name":"Correction eyelid w/implant","description":"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33202","name":"Insert epicard eltrd open","description":"Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median sternotomy, subxiphoid approach)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82507","name":"Assay of citrate","description":"Citrate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":80.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86378","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26434","name":"Repair/graft finger tendon","description":"Repair of extensor tendon, distal insertion, primary or secondary; with free graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20827","name":"Replantation thumb complete","description":"Replantation, thumb (includes distal tip to mp joint), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4403.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96542","name":"Chemotherapy injection","description":"Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44406","name":"Colonoscopy w/ultrasound","description":"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62304","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48548","name":"Fuse pancreas and bowel","description":"Pancreaticojejunostomy, side-to-side anastomosis (puestow-type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1392.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1009.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97165","name":"Ot eval low complex 30 min","description":"Occupational therapy evaluation, low complexity, requiring these components: an occupational profile and medical and therapy history, which includes a brief history including review of medical and/or therapy records relating to the presenting problem; an assessment(s) that identifies 1-3 performance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96103","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45112","name":"Removal of rectum","description":"Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1489.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17340","name":"Cryotherapy for acne","description":"Cryotherapy (co2 slush, liquid n2) for acne","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27665","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56800","name":"Plastic repair introitus","description":"Plastic repair of introitus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11755","name":"Biopsy nail unit","description":"Biopsy of nail unit (eg, plate, bed, matrix, hyponychium, proximal and lateral nail folds) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88387","name":"Macroscopic xm dsj&prep tiss","description":"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43239","name":"Egd biopsy single/multiple","description":"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96137","name":"Psycl/nrpsyc tst phy/qhp ea","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25280","name":"Revise wrist/forearm tendon","description":"Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50360","name":"Rnl altrnsplj w/o rcp nfrct","description":"Renal allotransplantation, implantation of graft; without recipient nephrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2105.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29843","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; for infection, lavage and drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75635","name":"Ct angio abdominal arteries","description":"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87328","name":"Cryptosporidium ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cryptosporidium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93247","name":"Ext ecg>7d<15d scan a/r","description":"External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58200","name":"Extensive hysterectomy","description":"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0186","name":"Dstry eye lesn,fdr vssl tech","description":"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64734","name":"Incision of cheek nerve","description":"Transection or avulsion of; infraorbital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93545","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20612","name":"Aspirate/inj ganglion cyst","description":"Aspiration and/or injection of ganglion cyst(s) any location","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21558","name":"Resect neck tumor 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33425","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2378.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86753","name":"Protozoa antibody nos","description":"Antibody; protozoa, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35623","name":"Bpg axillary-pop/-tibial","description":"Bypass graft, with other than vein; axillary-popliteal or -tibial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64831","name":"Repair of digit nerve","description":"Suture of digital nerve, hand or foot; 1 nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36261","name":"Revision of infusion pump","description":"Revision of implanted intra-arterial infusion pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42508","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27557","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64633","name":"Destroy cerv/thor facet jnt","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); cervical or thoracic, single facet joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26725","name":"Treat finger fracture each","description":"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25265","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90821","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25609","name":"Optx dst rd xart fx/ep sep3+","description":"Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77012","name":"Ct scan for needle biopsy","description":"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31825","name":"Repair of windpipe defect","description":"Surgical closure tracheostomy or fistula; with plastic repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27485","name":"Surgery to stop leg growth","description":"Arrest, hemiepiphyseal, distal femur or proximal tibia or fibula (eg, genu varus or valgus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78814","name":"Pet image w/ct lmtd","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3532.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17313","name":"Mohs 1 stage t/a/l","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53210","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; female","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47701","name":"Bile duct revision","description":"Portoenterostomy (eg, kasai procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1457.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20902","name":"Removal of bone for graft","description":"Bone graft, any donor area; major or large","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88235","name":"Tissue culture placenta","description":"Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85613","name":"Russell viper venom diluted","description":"Russell viper venom time (includes venom); diluted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27347","name":"Remove knee cyst","description":"Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71060","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69603","name":"Revj mstdc rsltg rad mstdc","description":"Revision mastoidectomy; resulting in radical mastoidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89141","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54430","name":"Revision of penis","description":"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":116.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27740","name":"Repair of leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41018","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01953","name":"Anes 2&3 burn ea add 9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; each additional 9% total body surface area or part thereof (list separately in addition to code for primary procedur","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47370","name":"Laparo ablate liver tumor rf","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82205","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82980","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43122","name":"Partial removal of esophagus","description":"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2131.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43415","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; transthoracic or transabdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2133.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","KL","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43216","name":"Esophagoscopy lesion removal","description":"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87116","name":"Mycobacteria culture","description":"Culture, tubercle or other acid-fast bacilli (eg, tb, afb, mycobacteria) any source, with isolation and presumptive identification of isolates","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":196.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74712","name":"Mri fetal sngl/1st gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35484","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53230","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); female","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2406.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82803","name":"Blood gases any combination","description":"Gases, blood, any combination of ph, pco2, po2, co2, hco3 (including calculated o2 saturation);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0130","name":"Single energy x-ray study","description":"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41823","name":"Excision of gum lesion","description":"Excision of osseous tuberosities, dentoalveolar structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68328","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1245.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1999.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29834","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; with removal of loose body or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85598","name":"Hexagnal phosph pltlt neutrl","description":"Phospholipid neutralization; hexagonal phospholipid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27557","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56637","name":"Vlvctmy rad comp bi lymphad","description":"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30200","name":"Injection treatment of nose","description":"Injection into turbinate(s), therapeutic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86833","name":"Hla class ii high defin qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, individual antigen per bead methodology), hla class ii","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76882","name":"Us lmtd jt/fcl evl nvasc xtr","description":"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22846","name":"Insert spine fixation device","description":"Anterior instrumentation; 4 to 7 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93229","name":"Remote 30 day ecg tech supp","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96160","name":"Pt-focused hlth risk assmt","description":"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20103","name":"Expl pentrg wound extremity","description":"Exploration of penetrating wound (separate procedure); extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21146","name":"Rcnstj mdfc lefort i 2 w/grf","description":"Reconstruction midface, lefort i; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral alveolar cleft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6473.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71271","name":"Ct thorax lung cancer scr c-","description":"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72147","name":"Mri chest spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54522","name":"Orchiectomy partial","description":"Orchiectomy, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8427","name":"Ready gradient glove","description":"Gradient pressure aid (glove), ready made","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4554.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","name":"Anes thrc spine w/1 lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0503","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44661","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; with intestine and/or bladder resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1270.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2006","name":"Post-d/c h vst ext pt 20 m","description":"Brief (20 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facili","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50389","name":"Remove renal tube w/fluoro","description":"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33694","name":"Cmp rpr tof wo plm atrs ptch","description":"Complete repair tetralogy of fallot without pulmonary atresia; with transannular patch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1698.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484T","name":"Tmvi transthoracic exposure","description":"Transcatheter mitral valve implantation/replacement (tmvi) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","name":"Anes c hyst flwg neuraxial","description":"Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23066","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; deep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27604","name":"Drain lower leg bursa","description":"Incision and drainage, leg or ankle; infected bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1514.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0420","name":"Ed svc ckd ind per session","description":"Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2146.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32854","name":"Lung transplant with bypass","description":"Lung transplant, double (bilateral sequential or en bloc); with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3934.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84379","name":"Sugars multiple quant","description":"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54060","name":"Excision of penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37241","name":"Vasc embolize/occlude venous","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2458.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99402","name":"Prev med cnsl indiv apprx 30","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","name":"Anes vag px crv cerclage","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27824","name":"Treat lower leg fracture","description":"Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67041","name":"Vit for macular pucker","description":"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61564","name":"Excision of skull tumor","description":"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2208.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33478","name":"Revision of heart chamber","description":"Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","name":"Anes male gent undscnd tstis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26775","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65755","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in pseudophakia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31780","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0498","name":"Chemo extend iv infus w/pump","description":"Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9432.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96406","name":"Chemo intralesional over 7","description":"Chemotherapy administration; intralesional, more than 7 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53275","name":"Repair of urethra defect","description":"Excision or fulguration; urethral prolapse","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33460","name":"Revision of tricuspid valve","description":"Valvectomy, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74712","name":"Mri fetal sngl/1st gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61550","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; single cranial suture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1075.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35540","name":"Art byp grft aortbifemoral","description":"Bypass graft, with vein; aortobifemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":152.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21340","name":"Perq tx nasoethmoid fx","description":"Percutaneous treatment of nasoethmoid complex fracture, with splint, wire or headcap fixation, including repair of canthal ligaments and/or the nasolacrimal apparatus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32662","name":"Thoracoscopy w/mediast exc","description":"Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28298","name":"Cor hlx vlgs prx phlx osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93619","name":"Comprehensive ep evaluation","description":"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":274.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00622","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27390","name":"Incision of thigh tendon","description":"Tenotomy, open, hamstring, knee to hip; single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61520","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3410.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52305","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87802","name":"Strep b assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group b","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4164","name":"Parenteral 50% dextrose solu","description":"Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L0210","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0290","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1840.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP07","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36596","name":"Mech remov tunneled cv cath","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28293","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83051","name":"Hemoglobin plasma","description":"Hemoglobin; plasma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92941","name":"Prq trlml revsc tot occl ami","description":"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single major coronary artery and/or its branches or single bypass g","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90901","name":"Biofeedback train any meth","description":"Biofeedback training by any modality","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23921","name":"Disarticulation sho sec clsr","description":"Disarticulation of shoulder; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37249","name":"Trluml balo angiop addl vein","description":"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; each additional vein (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25490","name":"Prophylactic tx radius","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15330","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59514","name":"Cesarean delivery only","description":"Cesarean delivery only;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54205","name":"Njx px peyronie ds exps plaq","description":"Injection procedure for peyronie disease; with surgical exposure of plaque","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63195","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86692","name":"Hepatitis delta agent antbdy","description":"Antibody; hepatitis, delta agent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64840","name":"Repair of leg nerve","description":"Suture of posterior tibial nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":62.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93014","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82565","name":"Assay of creatinine","description":"Creatinine; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43752","name":"Nasal/orogastric w/tube plmt","description":"Naso- or oro-gastric tube placement, requiring physicians skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99336","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15335","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49002","name":"Reopening of abdomen","description":"Reopening of recent laparotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51080","name":"Drainage of bladder abscess","description":"Drainage of perivesical or prevesical space abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15111","name":"Epidrm agrft t/a/l ea addl","description":"Epidermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0307","name":"Cbc without platelet","description":"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00561","name":"Anes px heart w/pump<1 yr","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25670","name":"Optx rdcrpl/ntrcrpl dislc 1+","description":"Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51550","name":"Partial removal of bladder","description":"Cystectomy, partial; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58661","name":"Laparoscopy remove adnexa","description":"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84681","name":"Assay of c-peptide","description":"C-peptide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78832","name":"Rp loclzj tum spect w/ct 2","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38221","name":"Dx bone marrow biopsies","description":"Diagnostic bone marrow; biopsy(ies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31365","name":"Removal of larynx","description":"Laryngectomy; total, with radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36640","name":"Insertion catheter artery","description":"Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21601","name":"Exc chest wall tumor w/ribs","description":"Excision of chest wall tumor including rib(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1020.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92611","name":"Motion fluoroscopy/swallow","description":"Motion fluoroscopic evaluation of swallowing function by cine or video recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83700","name":"Lipopro bld electrophoretic","description":"Lipoprotein, blood; electrophoretic separation and quantitation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58672","name":"Laparoscopy fimbrioplasty","description":"Laparoscopy, surgical; with fimbrioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15775","name":"Hair trnspl 1-15 punch grfts","description":"Punch graft for hair transplant; 1 to 15 punch grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49406","name":"Image cath fluid peri/retro","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53660","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22819","name":"Kyphectomy 3 or more","description":"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 or more segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2117.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78816","name":"Pet image w/ct full body","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78800","name":"Rp loclzj tum 1 area 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34421","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by leg incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63740","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93792","name":"Pt/caregiver traing home inr","description":"Patient/caregiver training for initiation of home international normalized ratio (inr) monitoring under the direction of a physician or other qualified health care professional, face-to-face, including use and care of the inr monitor, obtaining blood sample, instructions for reporting home inr test ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72141","name":"Mri neck spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19290","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35460","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24470","name":"Hemiepiphyseal arrest","description":"Hemiepiphyseal arrest (eg, cubitus varus or valgus, distal humerus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1413.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80195","name":"Assay of sirolimus","description":"Sirolimus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46748","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; with vaginal lengthening by intestinal graft or pedicle flaps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3561.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11400","name":"Exc tr-ext b9+marg 0.5 cm<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84165","name":"Protein e-phoresis serum","description":"Protein; electrophoretic fractionation and quantitation, serum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"Psytx w pt w e/m 60 min","description":"Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5642.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94644","name":"Cont inhlj tx 1st hour","description":"Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19367","name":"Brst rcnstj 1 pdcl tram flap","description":"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1150.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":251.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11752","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63185","name":"Incise spine nrv half segmnt","description":"Laminectomy with rhizotomy; 1 or 2 segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29904","name":"Subtalar arthro w/fb rmvl","description":"Arthroscopy, subtalar joint, surgical; with removal of loose body or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69635","name":"Repair eardrum structures","description":"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78483","name":"Heart first pass multiple","description":"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31649","name":"Bronchial valve remov addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31050","name":"Exploration sphenoid sinus","description":"Sinusotomy, sphenoid, with or without biopsy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93458","name":"L hrt artery/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31515","name":"Laryngoscopy for aspiration","description":"Laryngoscopy direct, with or without tracheoscopy; for aspiration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93306","name":"Tte w/doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32661","name":"Thoracoscopy w/pericard exc","description":"Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93464","name":"Exercise w/hemodynamic meas","description":"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3894.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46938","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3152.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90870","name":"Electroconvulsive therapy","description":"Electroconvulsive therapy (includes necessary monitoring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58940","name":"Removal of ovary(s)","description":"Oophorectomy, partial or total, unilateral or bilateral;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35518","name":"Art byp grft axillary-axilry","description":"Bypass graft, with vein; axillary-axillary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1009.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49082","name":"Abd paracentesis","description":"Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82963","name":"Assay of glucosidase","description":"Glucosidase, beta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19366","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6025","name":"Silicone gel sheet, each","description":"Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","name":"Anes 2&3 burn less 4 % tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; less than 4% total body surface area","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3526.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35638","name":"Bpg aortobi-iliac","description":"Bypass graft, with other than vein; aortobi-iliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49904","name":"Omental flap extra-abdom","description":"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35500","name":"Harvest vein for bypass","description":"Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32662","name":"Thoracoscopy w/mediast exc","description":"Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72149","name":"Mri lumbar spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82127","name":"Amino acid single qual","description":"Amino acids; single, qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47146","name":"Prep donor liver/venous","description":"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2201.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54900","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32815","name":"Close bronchial fistula","description":"Open closure of major bronchial fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2241.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01758","name":"Anes opn/arthrs elbw exc cst","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; excision of cyst or tumor of humerus","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95967","name":"Meg evoked each addl","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43756","name":"Dx duod intub w/asp spec","description":"Duodenal intubation and aspiration, diagnostic, includes image guidance; single specimen (eg, bile study for crystals or afferent loop culture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64835","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; median motor thenar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25520","name":"Cltx rdl shft fx&dislc","description":"Closed treatment of radial shaft fracture and closed treatment of dislocation of distal radioulnar joint (galeazzi fracture/dislocation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88141","name":"Cytopath c/v interpret","description":"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33030","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1736.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20102","name":"Expl pentrg wnd abd/flnk/bk","description":"Exploration of penetrating wound (separate procedure); abdomen/flank/back","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23615","name":"Optx prox humrl fx w/int fix","description":"Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54332","name":"Revise penis/urethra","description":"1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99186","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64550","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78433","name":"Myocrd img pet 2rtracer ct","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69711","name":"Remove/repair hearing aid","description":"Removal or repair of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54056","name":"Cryosurgery penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":185.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4543","name":"Adult disp brief/diap abv xl","description":"Adult sized disposable incontinence product, protective brief/diaper, above extra large, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4879.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69905","name":"Remove inner ear","description":"Labyrinthectomy; transcanal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47382","name":"Percut ablate liver rf","description":"Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6296.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36906","name":"Thrmbc/nfs dialysis circuit","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thromboly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3182.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62380","name":"Ndsc dcmprn 1 ntrspc lumbar","description":"Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4868.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93012","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71270","name":"Ct thorax dx c-/c+","description":"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85384","name":"Fibrinogen activity","description":"Fibrinogen; activity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45170","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27605","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); local anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40761","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (abbe-estlander type), including sectioning and inserting of pedicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15951","name":"Exc trchntr pr ulc ostc","description":"Excision, trochanteric pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64530","name":"N block inj celiac pelus","description":"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61684","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2621.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50540","name":"Revision of horseshoe kidney","description":"Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80164","name":"Assay dipropylacetic acd tot","description":"Valproic acid (dipropylacetic acid); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17262","name":"Dstrj mal les t/a/l 1.1-2.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44186","name":"Lap jejunostomy","description":"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83873","name":"Assay of csf protein","description":"Myelin basic protein, cerebrospinal fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47712","name":"Excision of bile duct tumor","description":"Excision of bile duct tumor, with or without primary repair of bile duct; intrahepatic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33417","name":"Repair of aortic valve","description":"Aortoplasty (gusset) for supravalvular stenosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1446.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33766","name":"Shunt supr v/c p-art 1 lung","description":"Shunt; superior vena cava to pulmonary artery for flow to 1 lung (classical glenn procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":976.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01430","name":"Anes px veins knee&pop nos","description":"Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27447","name":"Total knee arthroplasty","description":"Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1148.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31051","name":"Sphenoid sinus surgery","description":"Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57310","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26030","name":"Drainage of palm bursas","description":"Drainage of palmar bursa; multiple bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83912","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31660","name":"Bronch thermoplsty 1 lobe","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00756","name":"Anes hrna rpr diphrg hrna","description":"Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69020","name":"Drg xtrnl aud canal abscess","description":"Drainage external auditory canal, abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43773","name":"Lap replace gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82145","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84233","name":"Assay of estrogen","description":"Receptor assay; estrogen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81180","name":"Atxn3 gene detc abnor allele","description":"Atxn3 (ataxin 3) (eg, spinocerebellar ataxia, machado-joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92979","name":"Endoluminl ivus oct c ea","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to co","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80048","name":"Basic metabolic pnl total ca","description":"Basic metabolic panel (calcium, total) this panel must include the following: calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27784","name":"Treatment of fibula fracture","description":"Open treatment of proximal fibula or shaft fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43338","name":"Esoph lengthening","description":"Esophageal lengthening procedure (eg, collis gastroplasty or wedge gastroplasty) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26740","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; without manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35682","name":"Composite byp grft 2 veins","description":"Bypass graft; autogenous composite, 2 segments of veins from 2 locations (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95060","name":"Oph mucous membrane tests","description":"Ophthalmic mucous membrane tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33975","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","name":"Anes insj penile prosthesis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0084","name":"Care man h v ext pt 60 m","description":"Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64857","name":"Repair arm/leg nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88185","name":"Flowcytometry/tc add-on","description":"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (list separately in addition to code for first marker)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90862","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1431.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2217.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15820","name":"Blepharoplasty lower eyelid","description":"Blepharoplasty, lower eyelid;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93722","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29848","name":"Wrist endoscopy/surgery","description":"Endoscopy, wrist, surgical, with release of transverse carpal ligament","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44137","name":"Remove intestinal allograft","description":"Removal of transplanted intestinal allograft, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93016","name":"Cv stress test supvj only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64896","name":"Nrv grf mltst hnd/foot >4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1215.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93228","name":"Remote 30 day ecg rev/report","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95015","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50434","name":"Convert nephrostomy catheter","description":"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0064","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4210","name":"Orth dev repair/repl minor p","description":"Repair of orthotic device, repair or replace minor parts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95934","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11900","name":"Inject skin lesions </w 7","description":"Injection, intralesional; up to and including 7 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2248.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35637","name":"Bpg aortoiliac","description":"Bypass graft, with other than vein; aortoiliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1467.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86003","name":"Allg spec ige crude xtrc ea","description":"Allergen specific ige; quantitative or semiquantitative, crude allergen extract, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77012","name":"Ct scan for needle biopsy","description":"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75989","name":"Abscess drainage under x-ray","description":"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33404","name":"Prepare heart-aorta conduit","description":"Construction of apical-aortic conduit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1517.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87581","name":"M.pneumon dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2028.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97024","name":"Diathermy eg microwave","description":"Application of a modality to 1 or more areas; diathermy (eg, microwave)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25110","name":"Remove wrist tendon lesion","description":"Excision, lesion of tendon sheath, forearm and/or wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43415","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; transthoracic or transabdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2133.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86376","name":"Microsomal antibody each","description":"Microsomal antibodies (eg, thyroid or liver-kidney), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69502","name":"Mastoidectomy","description":"Mastoidectomy; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99192","name":"Special pump services","description":"Assembly and operation of pump with oxygenator or heat exchanger (with or without ecg and/or pressure monitoring); 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27095","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; with anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4045.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5194.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87176","name":"Tissue homogenization cultr","description":"Homogenization, tissue, for culture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19294","name":"Prepj tum cav iort prtl mast","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15847","name":"Exc skin abd add-on","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg, abdominoplasty) (includes umbilical transposition and fascial plication) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77421","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84156","name":"Assay of protein urine","description":"Protein, total, except by refractometry; urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21632","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1044.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0241","name":"Bath tub wall rail","description":"Bath tub wall rail, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28730","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93225","name":"Xtrnl ecg rec<48 hrs rec","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connection, recording, and disconnection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11307","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1801.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27323","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99378","name":"Hospice care supervision","description":"Supervision of a hospice patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26412","name":"Repair/graft hand tendon","description":"Repair, extensor tendon, hand, primary or secondary; with free graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61470","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35601","name":"Bpg com crtd-ipsi int crtd","description":"Bypass graft, with other than vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1233.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84315","name":"Body fluid specific gravity","description":"Specific gravity (except urine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87653","name":"Strep b dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group b, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12047","name":"Intmd rpr n-hf/genit >30.0cm","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36455","name":"Bld exchange truj oth thn nb","description":"Exchange transfusion, blood; other than newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27507","name":"Treatment of thigh fracture","description":"Open treatment of femoral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28050","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; intertarsal or tarsometatarsal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43248","name":"Egd guide wire insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30905","name":"Control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55680","name":"Remove sperm pouch lesion","description":"Excision of mullerian duct cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80435","name":"Insulin tolerance panel","description":"Insulin tolerance panel; for growth hormone deficiency this panel must include the following: glucose (82947 x 5) human growth hormone (hgh) (83003 x 5)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14000","name":"Tis trnfr trunk 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11104","name":"Punch bx skin single lesion","description":"Punch biopsy of skin (including simple closure, when performed); single lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44204","name":"Laparo partial colectomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1263.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51605","name":"Preparation for bladder xray","description":"Injection procedure and placement of chain for contrast and/or chain urethrocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32408","name":"Core ndl bx lng/med perq","description":"Core needle biopsy, lung or mediastinum, percutaneous, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78266","name":"Gstr empt img sm bwl&colon","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84702","name":"Chorionic gonadotropin test","description":"Gonadotropin, chorionic (hcg); quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25111","name":"Remove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); primary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88274","name":"Cytogenetics 25-99","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63035","name":"Lamot dcmprn nrv rt ea addl","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32852","name":"Lung transplant with bypass","description":"Lung transplant, single; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2859.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91313","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33967","name":"Insert i-aort percut device","description":"Insertion of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1097.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99466","name":"Ped crit care transport","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; first 30-74 minutes of hands-on care during transport","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61540","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1998.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0144T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1918.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1735.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22101","name":"Remove part thorax vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87910","name":"Nfct agt gntyp alys cmv","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); cytomegalovirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87177","name":"Ova and parasites smears","description":"Ova and parasites, direct smears, concentration and identification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28210","name":"Repair/graft of foot tendon","description":"Repair, tendon, extensor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43305","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86822","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49654","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84135","name":"Assay of pregnanediol","description":"Pregnanediol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10030","name":"Img gid flu coll drg sft tis","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76885","name":"Us exam infant hips dynamic","description":"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87338","name":"Hpylori stool ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; helicobacter pylori, stool","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35355","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliofemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4081","name":"Enteral ng tubing w/ stylet","description":"Nasogastric tubing with stylet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33522","name":"Cabg artery-vein five","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19303","name":"Mast simple complete","description":"Mastectomy, simple, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58293","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67445","name":"Explr/decompress eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of bone for decompression","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83925","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9507","name":"In111 capromab","description":"Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43232","name":"Esophagoscopy w/us needle bx","description":"Esophagoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35216","name":"Rpr blvsl dir ntrthrc wo byp","description":"Repair blood vessel, direct; intrathoracic, without bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1799.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54680","name":"Relocation of testis(es)","description":"Transplantation of testis(es) to thigh (because of scrotal destruction)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96119","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24535","name":"Cltx sprcndylr humeral fx w/","description":"Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30600","name":"Repair mouth/nose fistula","description":"Repair fistula; oronasal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47801","name":"Placement bile duct support","description":"Placement of choledochal stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63740","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["AW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80306","name":"Drug test prsmv instrmnt","description":"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59000","name":"Amniocentesis diagnostic","description":"Amniocentesis; diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6391.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]},{"negotiated_type":"negotiated","negotiated_rate":15771.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49405","name":"Image cath fluid colxn visc","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77048","name":"Mri breast c-+ w/cad uni","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77770","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["AU","AV","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38120","name":"Laparoscopy splenectomy","description":"Laparoscopy, surgical, splenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24587","name":"Optx partclr fx&/dslc elbw w","description":"Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius); with implant arthroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7261","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1777.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76979","name":"Us trgt dyn mbubb ea addl","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22208","name":"Incis spine 3 column adl seg","description":"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35302","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; superficial femoral artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88304","name":"Tissue exam by pathologist","description":"Level iii - surgical pathology, gross and microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque bartholins gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel t","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40800","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92284","name":"Dx dark adaptation exam i&r","description":"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78270","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92615","name":"Laryngoscopic sensory i&r","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46020","name":"Placement of seton","description":"Placement of seton","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52250","name":"Cystoscopy and radiotracer","description":"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28345","name":"Repair webbed toe(s)","description":"Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56740","name":"Exc bartholins gland/cyst","description":"Excision of bartholins gland or cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61710","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1972.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0123","name":"Screen cerv/vag thin layer","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99226","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64445","name":"Njx aa&/strd sciatic nrv img","description":"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11404","name":"Exc tr-ext b9+marg 3.1-4 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77770","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49255","name":"Removal of omentum","description":"Omentectomy, epiploectomy, resection of omentum (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35452","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92981","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33501","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0087","name":"Care man home care plan 60 m","description":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29836","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1766.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28292","name":"Cor hlx vlgs rsc prx phlx bs","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with resection of proximal phalanx base, when performed, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52648","name":"Laser surgery of prostate","description":"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62323","name":"Njx interlaminar lmbr/sac","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluorosc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33518","name":"Cabg artery-vein two","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 2 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0407","name":"Inpt/tele follow up 25","description":"Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95923","name":"Autonomic nrv syst funj test","description":"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1384.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98967","name":"Ph1 assmt&mgmt nqhp 11-20","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"Home/res vst new low mdm 30","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25440","name":"Repair nonu scphd carpl b1","description":"Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial styloidectomy (includes obtaining graft and necessary fixation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89230","name":"Collect sweat for test","description":"Sweat collection by iontophoresis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4570","name":"Splint","description":"Splint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73225","name":"Mr angio upr extr w/o&w/dye","description":"Magnetic resonance angiography, upper extremity, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57555","name":"Remove cervix/repair vagina","description":"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11310","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22853","name":"Insj biomechanical device","description":"Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (list separately in addition to code fo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55920","name":"Place needles pelvic for rt","description":"Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47715","name":"Excision of bile duct cyst","description":"Excision of choledochal cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1115.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","name":"Anes open total ankle rplcmt","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43756","name":"Dx duod intub w/asp spec","description":"Duodenal intubation and aspiration, diagnostic, includes image guidance; single specimen (eg, bile study for crystals or afferent loop culture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29125","name":"Appl short arm splint static","description":"Application of short arm splint (forearm to hand); static","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78473","name":"Gated heart multiple","description":"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23460.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21087","name":"Impres&prep nasal prosth","description":"Impression and custom preparation; nasal prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0111","name":"Wet mounts/ w preparations","description":"Wet mounts, including preparations of vaginal, cervical or skin specimens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52341","name":"Cysto w/ureter stricture tx","description":"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83894","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22319","name":"Treat odontoid fx w/graft","description":"Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with grafting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1663.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27279","name":"Arthrd si jt plmt tartclr dv","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of transarticular device(s) and/or intra-articular device(s) piercing the lateral or medial cortices of the ilium and the lateral cortex of the ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97605","name":"Neg prs wnd ther dme<=50sqcm","description":"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (dme), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26685","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41019","name":"Place needles h&n for rt","description":"Placement of needles, catheters, or other device(s) into the head and/or neck region (percutaneous, transoral, or transnasal) for subsequent interstitial radioelement application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47600","name":"Cholecystectomy","description":"Cholecystectomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2158.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82157","name":"Assay of androstenedione","description":"Androstenedione","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85379","name":"Fibrin degradation quant","description":"Fibrin degradation products, d-dimer; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35556","name":"Art byp grft fem-popliteal","description":"Bypass graft, with vein; femoral-popliteal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1233.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35523","name":"Art byp grft brchl-ulnr-rdl","description":"Bypass graft, with vein; brachial-ulnar or -radial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1126.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37247","name":"Trluml balo angiop addl art","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84600","name":"Assay of volatiles","description":"Volatiles (eg, acetic anhydride, diethylether)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62145","name":"Repair of skull & brain","description":"Cranioplasty for skull defect with reparative brain surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1297.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87556","name":"M.tuberculo dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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)","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24331","name":"Flexor-plasty elbw w/advmnt","description":"Flexor-plasty, elbow (eg, steindler type advancement); with extensor advancement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15773","name":"Grfg autol fat lipo 25 cc/<","description":"Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99223","name":"1st hosp ip/obs high 75","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8353.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49650","name":"Lap ing hernia repair init","description":"Laparoscopy, surgical; repair initial inguinal hernia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94774","name":"Ped home apnea mntr evnt rec","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; includes monitor attachment, download of data, review, interpretation, and preparation of a report by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93293","name":"Pm phone r-strip device eval","description":"Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4489.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59622","name":"Attempted vbac after care","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37201","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32906","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages); with closure of bronchopleural fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1320.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21347","name":"Opn tx nasomax fx multple","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); requiring multiple open approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77414","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33366","name":"Trcath replace aortic valve","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; transapical exposure (eg, left thoracotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1373.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31613","name":"Tracheostoma revj simple","description":"Tracheostoma revision; simple, without flap rotation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43121","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0455","name":"Fecal microbiota prep instil","description":"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77768","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93291","name":"Interrog dev eval scrms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; subcutaneous cardiac rhythm monitor system, including heart rhythm derived data analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75564","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64650","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; both axillae","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58970","name":"Retrieval of oocyte","description":"Follicle puncture for oocyte retrieval, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99475","name":"Ped crit care age 2-5 init","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22114","name":"Remove part lumbar vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58210","name":"Extensive hysterectomy","description":"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64865","name":"Repair of facial nerve","description":"Suture of facial nerve; infratemporal, with or without grafting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57285","name":"Repair paravag defect vag","description":"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27120","name":"Reconstruction of hip socket","description":"Acetabuloplasty; (eg, whitman, colonna, haygroves, or cup type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0034A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33621","name":"Transthor cath for stent","description":"Transthoracic insertion of catheter for stent placement with catheter removal and closure (eg, hybrid approach stage 1)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93229","name":"Remote 30 day ecg tech supp","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6012","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21199","name":"Reconstr lwr jaw w/advance","description":"Osteotomy, mandible, segmental; with genioglossus advancement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11056","name":"Parng/cutg b9 hyprkr les 2-4","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35474","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4536","name":"Reusable pull-on any size","description":"Incontinence product, protective underwear/pull-on, reusable, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2590.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28291","name":"Corrj halux rigdus w/implt","description":"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34847","name":"Visc & infraren abd 3 prosth","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2158.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68811","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96138","name":"Psycl/nrpsyc tech 1st","description":"Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73719","name":"Mri lower extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27006","name":"Tenotomy abductor&/xtnsr hip","description":"Tenotomy, abductors and/or extensor(s) of hip, open (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP05","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78835","name":"Rp quan meas single area","description":"Radiopharmaceutical quantification measurement(s) single area (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84597","name":"Assay of vitamin k","description":"Vitamin k","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88172","name":"Cytp dx eval fna 1st ea site","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32480","name":"Partial removal of lung","description":"Removal of lung, other than pneumonectomy; single lobe (lobectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1182.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"Family psytx w/pt 50 min","description":"Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35697","name":"Reimplant artery each","description":"Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52301","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77416","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73225","name":"Mr angio upr extr w/o&w/dye","description":"Magnetic resonance angiography, upper extremity, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21195","name":"Reconst lwr jaw w/o fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97163","name":"Pt eval high complex 45 min","description":"Physical therapy evaluation: high complexity, requiring these components: a history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; an examination of body systems using standardized tests and measures addressing a total of 4 or more elements from","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","name":"Anes px art lower leg emblc","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2160.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0117","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32661","name":"Thoracoscopy w/pericard exc","description":"Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75946","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89136","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25415","name":"Repair radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; without graft (eg, compression technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31590","name":"Reinnervate larynx","description":"Laryngeal reinnervation by neuromuscular pedicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87490","name":"Chlmyd trach dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57065","name":"Destruction vag lesion xtnsv","description":"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43651","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, truncal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33535","name":"Cabg arterial three","description":"Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2132.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8427","name":"Ready gradient glove","description":"Gradient pressure aid (glove), ready made","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82172","name":"Assay of apolipoprotein","description":"Apolipoprotein, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0435","name":"Oral hiv-1/hiv-2 screen","description":"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29835","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87390","name":"Hiv-1 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-1","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11750","name":"Excision nail&nail matrix","description":"Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31230","name":"Removal of upper jaw","description":"Maxillectomy; with orbital exenteration (en bloc)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1518.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5329.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278T","name":"Tempr","description":"Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47610","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83898","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61518","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2537.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50290","name":"Excision perinephric cyst","description":"Excision of perinephric cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90826","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32507","name":"Wedge resect of lung diag","description":"Thoracotomy; with diagnostic wedge resection followed by anatomic lung resection (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64585","name":"Rev/rmv perph nstim eltrd ra","description":"Revision or removal of peripheral neurostimulator electrode array","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27396","name":"Transplant of thigh tendon","description":"Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4168","name":"Parenteral sol amino acid 3.","description":"Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25025","name":"Decompress forearm 2 spaces","description":"Decompression fasciotomy, forearm and/or wrist, flexor and extensor compartment; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1016.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65781","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1852.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01682","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42225","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; attachment pharyngeal flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65870","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4335","name":"Incontinence supply","description":"Incontinence supply; miscellaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31020","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); intranasal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50561","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26412","name":"Repair/graft hand tendon","description":"Repair, extensor tendon, hand, primary or secondary; with free graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90827","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87207","name":"Smear special stain","description":"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36522","name":"Photopheresis","description":"Photopheresis, extracorporeal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1551.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80150","name":"Assay of amikacin","description":"Amikacin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51701","name":"Insert bladder catheter","description":"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":179.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15845","name":"Skin and muscle repair face","description":"Graft for facial nerve paralysis; regional muscle transfer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92563","name":"Tone decay hearing test","description":"Tone decay test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96371","name":"Sc ther infusion reset pump","description":"Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); additional pump set-up with establishment of new subcutaneous infusion site(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54162","name":"Lysis penil circumic lesion","description":"Lysis or excision of penile post-circumcision adhesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70470","name":"Ct head/brain w/o & w/dye","description":"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50580","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0113","name":"Pinworm examinations","description":"Pinworm examinations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0149T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82565","name":"Assay of creatinine","description":"Creatinine; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86602","name":"Antinomyces antibody","description":"Antibody; actinomyces","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86653","name":"Encephaltis st louis antbody","description":"Antibody; encephalitis, st. louis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","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, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2928.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24675","name":"Cltx ulnar fx prox w/mnpj","description":"Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36430","name":"Transfusion bld/bld compnt","description":"Transfusion, blood or blood components","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28476","name":"Prq skel fix metar fx w/mnpj","description":"Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64644","name":"Chemodenerv 1 extrem 5/> mus","description":"Chemodenervation of one extremity; 5 or more muscles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26235","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); proximal or middle phalanx of finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82131","name":"Amino acids single quant","description":"Amino acids; single, quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2842.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35661","name":"Bpg femoral-femoral","description":"Bypass graft, with other than vein; femoral-femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":953.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99306","name":"1st nf care high mdm 50","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes must be met or exceed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50700","name":"Revision of ureter","description":"Ureteroplasty, plastic operation on ureter (eg, stricture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63305","name":"Remove vert idrl body thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2296.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1556.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2572.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3250","name":"Custom mold shoe remov prost","description":"Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88333","name":"Path consltj surg cyto xm 1","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83698","name":"Assay lipoprotein pla2","description":"Lipoprotein-associated phospholipase a2 (lp-pla2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2590.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":40.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93582","name":"Perq transcath closure pda","description":"Percutaneous transcatheter closure of patent ductus arteriosus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0480","name":"Drug test def 1-7 classes","description":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27709","name":"Osteotomy tibia & fibula","description":"Osteotomy; tibia and fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83993","name":"Assay for calprotectin fecal","description":"Calprotectin, fecal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26118","name":"Rad resect hand tumor 3 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1901","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","name":"Anes integ sys rad brst dsj","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61618","name":"Repair dura","description":"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lata, adipose tissue, homologous or synthetic grafts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43277","name":"Ercp ea duct/ampulla dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with trans-endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla (sphincteroplasty), including sphincterotomy, when performed, each duct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2321.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":33.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52355","name":"Cystouretero w/excise tumor","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61697","name":"Brain aneurysm repr complx","description":"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3926.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52649","name":"Prostate laser enucleation","description":"Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4707","name":"Bicarbonate conc pow per pac","description":"Bicarbonate concentrate, powder, for hemodialysis, per packet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25112","name":"Reremove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); recurrent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43124","name":"Removal of esophagus","description":"Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3173.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64804","name":"Sympathectomy cervicothorac","description":"Sympathectomy, cervicothoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1075.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67340","name":"Revise eye muscle add-on","description":"Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82055","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46750","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; adult","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37207","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","name":"Anes hrna rpr lmbr&vnt&/dehs","description":"Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93233","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","name":"Anes px vn knee&pop av fstl","description":"Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43762","name":"Rplc gtube no revj trc","description":"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46040","name":"I&d ischiorct&/perirct absc","description":"Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":536.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37231","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7046.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29868","name":"Meniscal trnspl knee w/scpe","description":"Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"R0070","name":"Transport portable x-ray","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57230","name":"Repair of urethral lesion","description":"Plastic repair of urethrocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1003.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29584","name":"Appl mltlay cmprn sys up arm","description":"Application of multi-layer compression system; upper arm, forearm, hand, and fingers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90816","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83722","name":"Lipoprtn dir meas sd ldl chl","description":"Lipoprotein, direct measurement; small dense ldl cholesterol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2426.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93321","name":"Doppler echo f-up/lmtd std","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32096","name":"Open wedge/bx lung infiltr","description":"Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35536","name":"Art byp grft splenorenal","description":"Bypass graft, with vein; splenorenal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0321","name":"Audio-only hhs","description":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93651","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53010","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93750","name":"Interrogation vad in person","description":"Interrogation of ventricular assist device (vad), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of device function (eg, flow and volume status, septum status, recovery), with programming, if performe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35694","name":"Art trnsposj subclav carotid","description":"Transposition and/or reimplantation; subclavian to carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86652","name":"Encephaltis east eqne anbdy","description":"Antibody; encephalitis, eastern equine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55300","name":"Prepare sperm duct x-ray","description":"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33236","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; single lead system, atrial or ventricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":98.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29550","name":"Strapping of toes","description":"Strapping; toes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24201","name":"Rmvl fb upper arm/elbw deep","description":"Removal of foreign body, upper arm or elbow area; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6013","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57421","name":"Exam/biopsy of vag w/scope","description":"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4728.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":6506.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65782","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4818.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3265","name":"Plastazote sandal each","description":"Plastazote sandal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45825","name":"Repair fistula w/colostomy","description":"Closure of rectourethral fistula; with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99218","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65870","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15789","name":"Chemical peel facial dermal","description":"Chemical peel, facial; dermal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15361","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27440","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57135","name":"Excision vaginal cyst/tumor","description":"Excision of vaginal cyst or tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50688","name":"Change of ureter tube/stent","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93295","name":"Dev interrog remote 1/2/mlt","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23620","name":"Cltx gr hmrl tbrs fx wo mnpj","description":"Closed treatment of greater humeral tuberosity fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3157.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31370","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); horizontal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33120","name":"Exc icar tum resc w/card byp","description":"Excision of intracardiac tumor, resection with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1821.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20704","name":"Mnl prep&insj i-artic rx dev","description":"Manual preparation and insertion of drug-delivery device(s), intra-articular (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45900","name":"Reduction of rectal prolapse","description":"Reduction of procidentia (separate procedure) under anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61440","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1646.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","name":"Anes ther ivntl rad px icr","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17111","name":"Destruction b9 lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88154","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27357","name":"Remove femur lesion/graft","description":"Excision or curettage of bone cyst or benign tumor of femur; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96542","name":"Chemotherapy injection","description":"Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3132.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26075","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85400","name":"Fibrinolytic plasmin","description":"Fibrinolytic factors and inhibitors; plasmin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27122","name":"Reconstruction of hip socket","description":"Acetabuloplasty; resection, femoral head (eg, girdlestone procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2812.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35884","name":"Revj fem anast autog vn grf","description":"Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with autogenous vein patch graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6702.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58957","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47536","name":"Exchange biliary drg cath","description":"Exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69960","name":"Release inner ear canal","description":"Decompression internal auditory canal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22847","name":"Insert spine fixation device","description":"Anterior instrumentation; 8 or more vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70559","name":"Mri brain w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21431","name":"Cltx craniofacial separation","description":"Closed treatment of craniofacial separation (lefort iii type) using interdental wire fixation of denture or splint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1610.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64570","name":"Remove vagus n eltrd","description":"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67450","name":"Explore/biopsy eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); for exploration, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94668","name":"Mnpj chest wall sbsq","description":"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72158","name":"Mri lumbar spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30580","name":"Repair upper jaw fistula","description":"Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4193","name":"Parenteral sol 52-73 gm prot","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48152","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2430.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82340","name":"Assay of calcium in urine","description":"Calcium; urine quantitative, timed specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80069","name":"Renal function panel","description":"Renal function panel this panel must include the following: albumin (82040) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphorus inorganic (phosphate) (84100) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3217","name":"Ladies shoes hightop depth i","description":"Orthopedic footwear, ladies shoe, hightop, depth inlay, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47610","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37222","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33271","name":"Insj subq impltbl dfb elctrd","description":"Insertion of subcutaneous implantable defibrillator electrode","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97140","name":"Manual therapy 1/> regions","description":"Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2335.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37607","name":"Lig/banding angioacs av fstl","description":"Ligation or banding of angioaccess arteriovenous fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0031A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72159","name":"Mr angio spine w/o&w/dye","description":"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86671","name":"Fungus nes antibody","description":"Antibody; fungus, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98940","name":"Chiropract manj 1-2 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 1-2 regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87801","name":"Detect agnt mult dna ampli","description":"Infectious agent detection by nucleic acid (dna or rna), multiple organisms; amplified probe(s) technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11104","name":"Punch bx skin single lesion","description":"Punch biopsy of skin (including simple closure, when performed); single lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29715","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25270","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each tendon or muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","name":"Anes px heart w/pmp crc arst","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50060","name":"Nl removal calculus","description":"Nephrolithotomy; removal of calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94240","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86753","name":"Protozoa antibody nos","description":"Antibody; protozoa, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85250","name":"Clot factor ix ptc/chrstmas","description":"Clotting; factor ix (ptc or christmas)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54125","name":"Removal of penis","description":"Amputation of penis; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29870","name":"Arthrs knee dx w/wo syn bx","description":"Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71022","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0092","name":"Set up port xray equipment","description":"Set-up portable x-ray equipment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26035","name":"Decompress fingers/hand","description":"Decompression fingers and/or hand, injection injury (eg, grease gun)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20696","name":"App mltpln uni xtrnl fix 1st","description":"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; initial and subsequent alignment(s), assessment(s), and computation(s) of adjustment schedule(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15780","name":"Dermabrasion total face","description":"Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31400","name":"Revision of larynx","description":"Arytenoidectomy or arytenoidopexy, external approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74249","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46924","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87265","name":"Pertussis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; bordetella pertussis/parapertussis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33265","name":"Ablate atria lmtd endo","description":"Endoscopy, surgical; operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure), without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72147","name":"Mri chest spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95800","name":"Slp stdy unattended","description":"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50830","name":"Revise urine flow","description":"Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1457.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53000","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75571","name":"Ct hrt w/o dye w/ca test","description":"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76811","name":"Ob us detailed sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92273","name":"Full field erg w/i&r","description":"Electroretinography (erg), with interpretation and report; full field (ie, fferg, flash erg, ganzfeld erg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63281","name":"Bx/exc idrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1914.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82955","name":"Assay of g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P3000","name":"Screen pap by tech w md supv","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24410","name":"Mlt osteot rlgnm imed rd hum","description":"Multiple osteotomies with realignment on intramedullary rod, humeral shaft (sofield type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64722","name":"Decompression unspec nerve","description":"Decompression; unspecified nerve(s) (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43263","name":"Ercp sphincter pressure meas","description":"Endoscopic retrograde cholangiopancreatography (ercp); with pressure measurement of sphincter of oddi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87552","name":"Mycobacteria dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1162.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26485","name":"Transplant palm tendon","description":"Transfer or transplant of tendon, palmar; without free tendon graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92612","name":"Endoscopy swallow (fees) vid","description":"Flexible endoscopic evaluation of swallowing by cine or video recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6086.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2025","name":"Dis site tele svcs rhc/fqhc","description":"Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58275","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59015","name":"Chorion biopsy","description":"Chorionic villus sampling, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95973","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46760","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; muscle transplant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73202","name":"Ct uppr extremity w/o&w/dye","description":"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3531.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44364","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35631","name":"Bpg aor-celiac-msn-renal","description":"Bypass graft, with other than vein; aortoceliac, aortomesenteric, aortorenal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1634.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities: person-centered interview, performed to better understa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33500","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1354.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21451","name":"Cltx mndblr fx w/mnpj","description":"Closed treatment of mandibular fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0502","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67413","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20200","name":"Muscle biopsy superficial","description":"Biopsy, muscle; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21407","name":"Opn tx orbit fx w/implant","description":"Open treatment of fracture of orbit, except blowout; with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57320","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64435","name":"Njx aa&/strd paracrv nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87528","name":"Hsv dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0445","name":"High inten beh couns std 30m","description":"High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1730","name":"Cath, ep, 19 or few elect","description":"Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28043","name":"Exc foot/toe tum sc < 1.5 cm","description":"Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47555","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with dilation of biliary duct stricture(s) without stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86611","name":"Bartonella antibody","description":"Antibody; bartonella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95927","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69552","name":"Exc aurl glomus tum trnsmstd","description":"Excision aural glomus tumor; transmastoid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9982","name":"Remote e/m new pt 60mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28232","name":"Incision of toe tendon","description":"Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61576","name":"Skull base/brainstem surgery","description":"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3832.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4082","name":"Enteral ng tubing w/o stylet","description":"Nasogastric tubing without stylet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21083","name":"Impres&prep paltl lft prosth","description":"Impression and custom preparation; palatal lift prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92314","name":"C-lens fitg tech ou","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens, both eyes except for aphakia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54163","name":"Repair of circumcision","description":"Repair incomplete circumcision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1431.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12004","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65930","name":"Remove blood clot from eye","description":"Removal of blood clot, anterior segment of eye","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80439","name":"Trh stimulation panel","description":"Thyrotropin releasing hormone (trh) stimulation panel; 2 hour this panel must include the following: thyroid stimulating hormone (tsh) (84443 x 4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87520","name":"Hepatitis c rna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","name":"Anes xtrprtl lwr abd rnl px","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93325","name":"Doppler echo color flow mapg","description":"Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21340","name":"Perq tx nasoethmoid fx","description":"Percutaneous treatment of nasoethmoid complex fracture, with splint, wire or headcap fixation, including repair of canthal ligaments and/or the nasolacrimal apparatus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78584","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23490","name":"Reinforce clavicle","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; clavicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21206","name":"Reconstruct upper jaw bone","description":"Osteotomy, maxilla, segmental (eg, wassmund or schuchard)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43246","name":"Egd place gastrostomy tube","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64874","name":"Repair & revise nerve add-on","description":"Suture of nerve; requiring extensive mobilization, or transposition of nerve (list separately in addition to code for nerve suture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11105","name":"Punch bx skin ea sep/addl","description":"Punch biopsy of skin (including simple closure, when performed); each separate/additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46221","name":"Ligation of hemorrhoid(s)","description":"Hemorrhoidectomy, internal, by rubber band ligation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0506","name":"Comp asses care plan ccm svc","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21100","name":"Maxillofacial fixation","description":"Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","name":"Anes clsd px shoulder joint","description":"Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36251","name":"Ins cath ren art 1st unilat","description":"Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and inte","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1136.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17286","name":"Dstr mal ls f/e/e/n/l/m>4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4262","name":"Temporary tear duct plug","description":"Temporary, absorbable lacrimal duct implant, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33365","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15834","name":"Exc excessive skin hip","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"Home/res vst est sf mdm 20","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceede","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86481","name":"Tb ag response t-cell susp","description":"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing t-cells in cell suspension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01810","name":"Anes px nrv musc f/arm wrst","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50740","name":"Fusion of ureter & kidney","description":"Ureteropyelostomy, anastomosis of ureter and renal pelvis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76937","name":"Us guide vascular access","description":"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","name":"Anes hrna rpr upr abd nos","description":"Anesthesia for hernia repairs in upper abdomen; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93650","name":"Icar cath abltj av node func","description":"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47802","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16030","name":"Dress/debrid p-thick burn l","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2246.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35493","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27786","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19083","name":"Bx breast 1st lesion us imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44640","name":"Repair bowel-skin fistula","description":"Closure of intestinal cutaneous fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1154.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49521","name":"Rerepair ing hernia blocked","description":"Repair recurrent inguinal hernia, any age; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70554","name":"Fmri brain by tech","description":"Magnetic resonance imaging, brain, functional mri; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90809","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26420","name":"Repair/graft finger tendon","description":"Repair, extensor tendon, finger, primary or secondary; with free graft (includes obtaining graft) each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21465","name":"Optx mndblr cndylr fx","description":"Open treatment of mandibular condylar fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B5200","name":"Parenteral sol hepatic fream","description":"Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, stress-branch chain amino acids-freamine-hbc-premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87425","name":"Rotavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; rotavirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78472","name":"Gated heart planar single","description":"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93724","name":"Elec alys antitchycar pm sys","description":"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31238","name":"Nsl/sins ndsc srg nsl hemrrg","description":"Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75774","name":"Artery x-ray each vessel","description":"Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78709","name":"K flow/funct image multiple","description":"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61799","name":"Srs cran les complex addl","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27333","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial and lateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85547","name":"Rbc mechanical fragility","description":"Mechanical fragility, rbc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36815","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13151","name":"Cmplx rpr e/n/e/l 1.1-2.5 cm","description":"Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45990","name":"Surg dx exam anorectal","description":"Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83150","name":"Assay of homovanillic acid","description":"Homovanillic acid (hva)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1124.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73722","name":"Mri joint of lwr extr w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26140","name":"Revise finger joint each","description":"Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81178","name":"Atxn1 gene detc abnor allele","description":"Atxn1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66820","name":"Incision secondary cataract","description":"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (ziegler or wheeler knife)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62272","name":"Ther spi pnxr drg csf","description":"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60512","name":"Autotransplant parathyroid","description":"Parathyroid autotransplantation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25492","name":"Prophylactic tx radius&ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius and ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","name":"Anes px vn upr arm&elbw nos","description":"Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4269","name":"Spermicide","description":"Contraceptive supply, spermicide (e.g., foam, gel), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87899","name":"Agent nos assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93642","name":"Ep evl 1/2chmb trnsvns cvdfb","description":"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parame","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89310","name":"Semen analysis w/count","description":"Semen analysis; motility and count (not including huhner test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94370","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3817.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78433","name":"Myocrd img pet 2rtracer ct","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2251.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17271","name":"Dstr mal les s/n/h/f/g 0.6-1","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47525","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92556","name":"Speech audiometry complete","description":"Speech audiometry threshold; with speech recognition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5419.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81187","name":"Cnbp gene detc abnor allele","description":"Cnbp (cchc-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75561","name":"Cardiac mri for morph w/dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1605.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33697","name":"Compl rpr tof w/pulm atresia","description":"Complete repair tetralogy of fallot with pulmonary atresia including construction of conduit from right ventricle to pulmonary artery and closure of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30620","name":"Intranasal reconstruction","description":"Septal or other intranasal dermatoplasty (does not include obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49500","name":"Rpr ing hernia init reduce","description":"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","name":"Anes open/arthr ntrthrc amp","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; interthoracoscapular (forequarter) amputation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47015","name":"Lapt aspir&/njx hep prst cst","description":"Laparotomy, with aspiration and/or injection of hepatic parasitic (eg, amoebic or echinococcal) cyst(s) or abscess(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33684","name":"Clsr 1 vsd w/wo patch w/vlvt","description":"Closure of single ventricular septal defect, with or without patch; with pulmonary valvotomy or infundibular resection (acyanotic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1643.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74245","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92508","name":"Tx sp lang voice comm group","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5299.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45305","name":"Proctosigmoidoscopy w/bx","description":"Proctosigmoidoscopy, rigid; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63700","name":"Repair of spinal herniation","description":"Repair of meningocele; less than 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1184.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77336","name":"Radiation physics consult","description":"Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76816","name":"Ob us follow-up per fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetu","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66990","name":"Ophthalmic endoscope add-on","description":"Use of ophthalmic endoscope (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21602","name":"Exc ch wal tum w/o lymphadec","description":"Excision of chest wall tumor involving rib(s), with plastic reconstruction; without mediastinal lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1359.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65775","name":"Correction of astigmatism","description":"Corneal wedge resection for correction of surgically induced astigmatism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21501","name":"I&d dp absc/hmtma sft ts nck","description":"Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29822","name":"Sho arthrs srg lmtd dbrdmt","description":"Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78816","name":"Pet image w/ct full body","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28296","name":"Cor hlx vlgs dstl mtar osteo","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97761","name":"Prosthetic traing 1st enc","description":"Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34800","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89330","name":"Evaluation cervical mucus","description":"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77048","name":"Mri breast c-+ w/cad uni","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L8010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2451.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","name":"Anes opn/arthr tot sho rplcm","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13131","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","description":"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27132","name":"Total hip arthroplasty","description":"Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1421.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84181","name":"Western blot test","description":"Protein; western blot, with interpretation and report, blood or other body fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61460","name":"Crnec sopl sctj 1+crnl nrv","description":"Craniectomy, suboccipital; for section of 1 or more cranial nerves","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1930.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":575.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64560","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63191","name":"Incise spine accessory nerve","description":"Laminectomy with section of spinal accessory nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1255.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22612","name":"Arthrd pst tq 1ntrspc lumbar","description":"Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1394.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64595","name":"Rev/rmv prph sac/gstr npg/r","description":"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87472","name":"Bartonella dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); bartonella henselae and bartonella quintana, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6455.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75571","name":"Ct hrt w/o dye w/ca test","description":"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39561","name":"Resect diaphragm complex","description":"Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67113","name":"Repair retinal detach cplx","description":"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage c-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamp","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40818","name":"Excise oral mucosa for graft","description":"Excision of mucosa of vestibule of mouth as donor graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33980","name":"Remove intracorporeal device","description":"Removal of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1549.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88237","name":"Tissue culture bone marrow","description":"Tissue culture for neoplastic disorders; bone marrow, blood cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47538","name":"Perq plmt bile duct stent","description":"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; existing ac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82600","name":"Assay of cyanide","description":"Cyanide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90913","name":"Bfb training ea addl 15 min","description":"Biofeedback training, perineal muscles, anorectal or urethral sphincter, including emg and/or manometry, when performed; each additional 15 minutes of one-on-one physician or other qualified health care professional contact with the patient (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0207T","name":"Clear eyelid gland w/heat","description":"Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0890","name":"Pwc gp5 ped sing pow opt s/b","description":"Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6967.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21230","name":"Rib cartilage graft","description":"Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3174.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64410","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"Home/res vst new high mdm 75","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1189.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89132","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26861","name":"Fusion of finger jnt add-on","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; each additional interphalangeal joint (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29010","name":"Appl risser jacket body only","description":"Application of risser jacket, localizer, body; only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27185","name":"Revision of femur epiphysis","description":"Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":713.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54640","name":"Orchiopexy ingun/scrot appr","description":"Orchiopexy, inguinal or scrotal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73550","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93976","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25660","name":"Cltx rdcrpl/ntrcrpl dislc 1+","description":"Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1891.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31000","name":"Irrigation maxillary sinus","description":"Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43045","name":"Esophagotomy thrc rmvl fb","description":"Esophagotomy, thoracic approach, with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64865","name":"Repair of facial nerve","description":"Suture of facial nerve; infratemporal, with or without grafting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28112","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; other metatarsal head (second, third or fourth)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76826","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27329","name":"Resect thigh/knee tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85380","name":"Fibrin degradj d-dimer","description":"Fibrin degradation products, d-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32655","name":"Thoracoscopy resect bullae","description":"Thoracoscopy, surgical; with resection-plication of bullae, includes any pleural procedure when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86759","name":"Rotavirus antibody","description":"Antibody; rotavirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41806","name":"Removal foreign body jawbone","description":"Removal of embedded foreign body from dentoalveolar structures; bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4168","name":"Parenteral sol amino acid 3.","description":"Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33641","name":"Repair heart septum defect","description":"Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or without patch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1425.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27664","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519T","name":"Rmv&rplcmt pg wcs lv both","description":"Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; both components (battery and transmitter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43341","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); thoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26483","name":"Transplant/graft hand tendon","description":"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; with free tendon graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11828.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3617.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C2617","name":"Stent, non-cor, tem w/o del","description":"Stent, non-coronary, temporary, without delivery system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35666","name":"Bpg fem-ant tib pst tib/prnl","description":"Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1119.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26991","name":"Drainage of pelvis bursa","description":"Incision and drainage, pelvis or hip joint area; infected bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73722","name":"Mri joint of lwr extr w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92002","name":"Intrm oph exam new patient","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4478.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35651","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1427.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0108","name":"W/c component-accessory nos","description":"Wheelchair component or accessory, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61641","name":"Dilat ic vspsm ea vsl sm ter","description":"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75946","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33947","name":"Ecmo/ecls initiation artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-arterial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89105","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4770","name":"Blood collection tube/vacuum","description":"Blood collection tube, vacuum, for dialysis, per 50","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57106","name":"Vagnc prtl rmvl vag wall","description":"Vaginectomy, partial removal of vaginal wall;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54112","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft greater than 5 cm in length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","name":"Anes upr gi ndsc px nos","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93986","name":"Dup-scan hemo compl uni std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75954","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38542","name":"Explore deep node(s) neck","description":"Dissection, deep jugular node(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54308","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87512","name":"Gardner vag dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26123","name":"Release palm contracture","description":"Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15841","name":"Nerve palsy muscle graft","description":"Graft for facial nerve paralysis; free muscle graft (including obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77418","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95717","name":"Eeg phys/qhp 2-12 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2-12 hours of eeg recording; without video","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46940","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33220","name":"Repair lead pace-defib dual","description":"Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87273","name":"Herpes simplex 2 ag if","description":"Infectious agent antigen detection by immunofluorescent technique; herpes simplex virus type 2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50750","name":"Fusion of ureter & kidney","description":"Ureterocalycostomy, anastomosis of ureter to renal calyx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50562","name":"Renal scope w/tumor resect","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64772","name":"Incision of spinal nerve","description":"Transection or avulsion of other spinal nerve, extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73522","name":"X-ray exam hips bi 3-4 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24343","name":"Repr elbow lat ligmnt w/tiss","description":"Repair lateral collateral ligament, elbow, with local tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43100","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76376","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"Speech threshold audiometry","description":"Speech audiometry threshold;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23660","name":"Optx acute shoulder dislc","description":"Open treatment of acute shoulder dislocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33273","name":"Repos prev impltbl subq dfb","description":"Repositioning of previously implanted subcutaneous implantable defibrillator electrode","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36592","name":"Collect blood from picc","description":"Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85378","name":"Fibrin degrade semiquant","description":"Fibrin degradation products, d-dimer; qualitative or semiquantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50553","name":"Kidney endoscopy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01850","name":"Anes vein f/arm wrst&hnd nos","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64627","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53431","name":"Reconstruct urethra/bladder","description":"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, tenago, leadbetter procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93297","name":"Rem interrog dev eval icpms","description":"Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors, analysis, review(s) and report(s) by a physician or other quali","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","name":"Anes hrna rpr lmbr&vnt&/dehs","description":"Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0269","name":"Occlusive device in vein art","description":"Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29345","name":"Application of long leg cast","description":"Application of long leg cast (thigh to toes);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1532.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97016","name":"Vasopneumatic device therapy","description":"Application of a modality to 1 or more areas; vasopneumatic devices","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35636","name":"Bpg splenorenal","description":"Bypass graft, with other than vein; splenorenal (splenic to renal arterial anastomosis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1409.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75559","name":"Cardiac mri w/stress img","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3415.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7076.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4470.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84307","name":"Assay of somatostatin","description":"Somatostatin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46607","name":"Diagnostic anoscopy & biopsy","description":"Anoscopy; with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86727","name":"Lymph choriomeningitis ab","description":"Antibody; lymphocytic choriomeningitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23075","name":"Exc shoulder les sc < 3 cm","description":"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93314","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29879","name":"Arthrs kne srg abrasj arthrp","description":"Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4267","name":"Male condom","description":"Contraceptive supply, condom, male, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39200","name":"Resect mediastinal cyst","description":"Resection of mediastinal cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU","AV"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81286","name":"Fxn gene full gene sequence","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; full gene sequence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3997.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01232","name":"Anes opn px upr 2/3 fem amp","description":"Anesthesia for open procedures involving upper two-thirds of femur; amputation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73523","name":"X-ray exam hips bi 5/> views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21256","name":"Reconstruction of orbit","description":"Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84311","name":"Spectrophotometry","description":"Spectrophotometry, analyte not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86704","name":"Hep b core antibody total","description":"Hepatitis b core antibody (hbcab); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43278","name":"Ercp lesion ablate w/dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with ablation of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78591","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83528","name":"Assay of intrinsic factor","description":"Intrinsic factor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43635","name":"Removal of stomach partial","description":"Vagotomy when performed with partial distal gastrectomy (list separately in addition to code[s] for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93453","name":"R&l hrt cath w/ventriclgrphy","description":"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","name":"Anes iper upr abd pncrtect","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, whipple procedure)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2482.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72149","name":"Mri lumbar spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41826","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33877","name":"Thoracoabdominal graft","description":"Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3184.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93318","name":"Echo transesophageal intraop","description":"Echocardiography, transesophageal (tee) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78272","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61050","name":"Remove brain canal fluid","description":"Cisternal or lateral cervical (c1-c2) puncture; without injection (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97162","name":"Pt eval mod complex 30 min","description":"Physical therapy evaluation: moderate complexity, requiring these components: a history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; an examination of body systems using standardized tests and measures in addressing a total of 3 or more elements fro","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32820","name":"Reconstruct injured chest","description":"Major reconstruction, chest wall (posttraumatic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0190T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2285.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32506","name":"Wedge resect of lung add-on","description":"Thoracotomy; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35536","name":"Art byp grft splenorenal","description":"Bypass graft, with vein; splenorenal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"Review patient spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; review and interpretation only by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64565","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21243","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with prosthetic joint replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1309.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75978","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87267","name":"Enterovirus antibody dfa","description":"Infectious agent antigen detection by immunofluorescent technique; enterovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21601","name":"Exc chest wall tumor w/ribs","description":"Excision of chest wall tumor including rib(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1020.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21800","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51940","name":"Correction of bladder defect","description":"Closure, exstrophy of bladder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1326.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2169.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63271","name":"Excise intrspinl lesion thrc","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1890.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22585","name":"Arthrd ant ntrbd min dsc ea","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61584","name":"Orbitocranial approach/skull","description":"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2584.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31561","name":"Larynscop remve cart + scop","description":"Laryngoscopy, direct, operative, with arytenoidectomy; with operating microscope or telescope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80299","name":"Quantitative assay drug","description":"Quantitation of therapeutic drug, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20650","name":"Insert and remove bone pin","description":"Insertion of wire or pin with application of skeletal traction, including removal (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, manual","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62367","name":"Analyze spine infus pump","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming or refill","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93976","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62328","name":"Dx lmbr spi pnxr w/fluor/ct","description":"Spinal puncture, lumbar, diagnostic; with fluoroscopic or ct guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76513","name":"Oph us dx ant sgm us uni/bi","description":"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) b-scan or high resolution biomicroscopy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92228","name":"Img rta detc/mntr ds phy/qhp","description":"Imaging of retina for detection or monitoring of disease; with remote physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19305","name":"Mast radical","description":"Mastectomy, radical, including pectoral muscles, axillary lymph nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38505","name":"Needle biopsy lymph nodes","description":"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"Meas lung vol thru 2 yrs","description":"Measurement of lung volumes (ie, functional residual capacity [frc], forced vital capacity [fvc], and expiratory reserve volume [erv]) in an infant or child through 2 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0027","name":"Semen analysis","description":"Semen analysis; presence and/or motility of sperm excluding huhner","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32669","name":"Thoracoscopy remove segment","description":"Thoracoscopy, surgical; with removal of a single lung segment (segmentectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1075.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77768","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59812","name":"Treatment of miscarriage","description":"Treatment of incomplete abortion, any trimester, completed surgically","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88271","name":"Cytogenetics dna probe","description":"Molecular cytogenetics; dna probe, each (eg, fish)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21143","name":"Rcnstj mdface lefort i 3/>pc","description":"Reconstruction midface, lefort i; 3 or more pieces, segment movement in any direction, without bone graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1140.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81182","name":"Atxn8os gen detc abnor allel","description":"Atxn8os (atxn8 opposite strand [non-protein coding]) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32405","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31267","name":"Endoscopy maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97170","name":"Athletic trn eval mod cmplx","description":"Athletic training evaluation, moderate complexity, requiring these components: a medical history and physical activity profile with 1-2 comorbidities that affect physical activity; an examination of affected body area and other symptomatic or related systems addressing a total of 3 or more elements ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89320","name":"Semen anal vol/count/mot","description":"Semen analysis; volume, count, motility, and differential","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92604","name":"Reprogram cochlear implt 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60212","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81187","name":"Cnbp gene detc abnor allele","description":"Cnbp (cchc-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25312","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; with tendon graft(s) (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87187","name":"Sc std microdil/agar mlc","description":"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (mlc), each plate (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00622","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93623","name":"Prgrmd stimj&pacg iv rx nfs","description":"Programmed stimulation and pacing after intravenous drug infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33410","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with stentless tissue valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2213.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6205","name":"Composite drsg > 48 sq in","description":"Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99318","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68440","name":"Snip inc lacrimal punctum","description":"Snip incision of lacrimal punctum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24147","name":"Prtl exc bone olecrn process","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77049","name":"Mri breast c-+ w/cad bi","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88720","name":"Bilirubin total transcut","description":"Bilirubin, total, transcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92602","name":"Reprogram cochlear implt <7","description":"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2072.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27425","name":"Lat retinacular release open","description":"Lateral retinacular release, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23190","name":"Ostectomy scapula partial","description":"Ostectomy of scapula, partial (eg, superior medial angle)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69421","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96130","name":"Psycl tst eval phys/qhp 1st","description":"Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32503","name":"Resect apical lung tumor","description":"Resection of apical lung tumor (eg, pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; without chest wall reconstruction(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99494","name":"1st/sbsq psyc collab care","description":"Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96040","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0124","name":"Screen c/v thin layer by md","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84830","name":"Ovulation tests","description":"Ovulation tests, by visual color comparison methods for human luteinizing hormone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61703","name":"Clamp neck artery","description":"Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (selverstone-crutchfield type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1238.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62305","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33237","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; dual lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28072","name":"Removal of foot joint lining","description":"Synovectomy; metatarsophalangeal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","name":"Anes integ sys rad brst dsj","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64491","name":"Inj paravert f jnt c/t 2 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67950","name":"Revision of eyelid","description":"Canthoplasty (reconstruction of canthus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35304","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; tibioperoneal trunk artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53240","name":"Surgery for urethra pouch","description":"Marsupialization of urethral diverticulum, male or female","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36680","name":"Insert needle bone cavity","description":"Placement of needle for intraosseous infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35206","name":"Repair blood vessel dir uxtr","description":"Repair blood vessel, direct; upper extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34832","name":"Open aortofemor prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bifemoral prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1676.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69632","name":"Rebuild eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48105","name":"Resect/debride pancreas","description":"Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2356.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27429","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93572","name":"Iv dop vel&/press c flo ea","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2147.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62369","name":"Anal sp inf pmp w/reprg&fill","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33315","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1662.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7866.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3102.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29807","name":"Sho arthrs srg rpr slap les","description":"Arthroscopy, shoulder, surgical; repair of slap lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70492","name":"Ct sft tsue nck w/o & w/dye","description":"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53425","name":"Reconstruct urethra stage 2","description":"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61533","name":"Implant brain electrodes","description":"Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1394.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87521","name":"Hepatitis c probe&rvrs trnsc","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35538","name":"Art byp grft aortobi-iliac","description":"Bypass graft, with vein; aortobi-iliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26706","name":"Pin knuckle dislocation","description":"Percutaneous skeletal fixation of metacarpophalangeal dislocation, single, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21450","name":"Cltx mndblr fx w/o mnpj","description":"Closed treatment of mandibular fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86430","name":"Rheumatoid factor test qual","description":"Rheumatoid factor; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43622","name":"Removal of stomach","description":"Gastrectomy, total; with formation of intestinal pouch, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1946.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3179.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43652","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86886","name":"Coombs test indirect titer","description":"Antihuman globulin test (coombs test); indirect, each antibody titer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32994","name":"Ablate pulm tumor perq crybl","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56441","name":"Lysis of labial adhesions","description":"Lysis of labial adhesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10737.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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 (","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33620","name":"Apply r&l pulm art bands","description":"Application of right and left pulmonary artery bands (eg, hybrid approach stage 1)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1435.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67220","name":"Treatment of choroid lesion","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92201","name":"Opscpy extnd rta draw uni/bi","description":"Ophthalmoscopy, extended; with retinal drawing and scleral depression of peripheral retinal disease (eg, for retinal tear, retinal detachment, retinal tumor) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5892.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94669","name":"Mechanical chest wall oscill","description":"Mechanical chest wall oscillation to facilitate lung function, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31090","name":"Exploration of sinuses","description":"Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92512","name":"Nasal function studies","description":"Nasal function studies (eg, rhinomanometry)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84540","name":"Assay of urine/urea-n","description":"Urea nitrogen, urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99217","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21385","name":"Opn tx orbit fx transantral","description":"Open treatment of orbital floor blowout fracture; transantral approach (caldwell-luc type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2996.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83719","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; vldl cholesterol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","name":"Anes px crv spn&cord sitting","description":"Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26350","name":"Repair finger/hand tendon","description":"Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no mans land); primary or secondary without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, manual","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76000","name":"Fluoroscopy <1 hr phys/qhp","description":"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"Speech threshold audiometry","description":"Speech audiometry threshold;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82239","name":"Bile acids total","description":"Bile acids; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23350","name":"Injection for shoulder x-ray","description":"Injection procedure for shoulder arthrography or enhanced ct/mri shoulder arthrography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3296.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23466","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, any type multidirectional instability","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28300","name":"Incision of heel bone","description":"Osteotomy; calcaneus (eg, dwyer or chambers type procedure), with or without internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24600","name":"Tx clsd elbow dislc w/o anes","description":"Treatment of closed elbow dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35231","name":"Repair blvsl vn grf neck","description":"Repair blood vessel with vein graft; neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6008","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92979","name":"Endoluminl ivus oct c ea","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to co","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82785","name":"Assay of ige","description":"Gammaglobulin (immunoglobulin); ige","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44379","name":"S bowel endoscope w/stent","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93232","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94453","name":"Hast w/suppl oxygen titrj","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36830","name":"Artery-vein nonautograft","description":"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73522","name":"X-ray exam hips bi 3-4 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88350","name":"Imfluor ea addl 1antb stn px","description":"Immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64892","name":"Nrv grf 1strnd arm/leg <4cm","description":"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11977","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24110","name":"Exc/curtg b1 cst/b9 tum hum","description":"Excision or curettage of bone cyst or benign tumor, humerus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","name":"Anes opn px upr tib fib&/pat","description":"Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44312","name":"Revision of ileostomy","description":"Revision of ileostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15792","name":"Chem peel nonfacial epidrm","description":"Chemical peel, nonfacial; epidermal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449T","name":"Insj aqueous drain dev 1st","description":"Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; initial device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82926","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1340.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80424","name":"Glucagon tolerance panel","description":"Glucagon tolerance panel; for pheochromocytoma this panel must include the following: catecholamines, fractionated (82384 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11312","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43180","name":"Esophagoscopy rigid trnso","description":"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, zenkers diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope and repair, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80103","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43030","name":"Cricopharyngeal myotomy","description":"Cricopharyngeal myotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70496","name":"Ct angiography head","description":"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96368","name":"Ther/diag concurrent inf","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78494","name":"Heart image spect","description":"Cardiac blood pool imaging, gated equilibrium, spect, at rest, wall motion study plus ejection fraction, with or without quantitative processing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25290","name":"Incise wrist/forearm tendon","description":"Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4162","name":"Ef ped specmetabolic inherit","description":"Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85306","name":"Clot inhibit prot s free","description":"Clotting inhibitors or anticoagulants; protein s, free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46250","name":"Remove ext hem groups 2+","description":"Hemorrhoidectomy, external, 2 or more columns/groups","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1352.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86688","name":"Htlv-ii antibody","description":"Antibody; htlv-ii","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1922.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50945","name":"Laparoscopy ureterolithotomy","description":"Laparoscopy, surgical; ureterolithotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP21","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32550","name":"Insert pleural cath","description":"Insertion of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":86.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63650","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array, epidural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90959","name":"Esrd serv 1 vst p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional per mont","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81171","name":"Aff2 gen aly detc abnl allel","description":"Aff2 (alf transcription elongation factor 2 [fmr2]) (eg, fragile x intellectual disability 2 [fraxe]) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","name":"Anes insj penile prosthesis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63295","name":"Repair laminectomy defect","description":"Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85420","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21603","name":"Exc ch wal tum w/lymphadec","description":"Excision of chest wall tumor involving rib(s), with plastic reconstruction; with mediastinal lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1509.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86689","name":"Htlv/hiv confirmj antibody","description":"Antibody; htlv or hiv antibody, confirmatory test (eg, western blot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74170","name":"Ct abd wo cntrst flwd cntrst","description":"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33475","name":"Replacement pulmonary valve","description":"Replacement, pulmonary valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2024.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28750","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; metatarsophalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20525","name":"Rmvl fb musc/tdn deep/comp","description":"Removal of foreign body in muscle or tendon sheath; deep or complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99318","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27176","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by single or multiple pinning, in situ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21700","name":"Revision of neck muscle","description":"Division of scalenus anticus; without resection of cervical rib","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8750.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84206","name":"Assay of proinsulin","description":"Proinsulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43123","name":"Partial removal of esophagus","description":"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3775.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27470","name":"Repair of thigh","description":"Repair, nonunion or malunion, femur, distal to head and neck; without graft (eg, compression technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50520","name":"Close kidney-skin fistula","description":"Closure of nephrocutaneous or pyelocutaneous fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0483","name":"Drug test def 22+ classes","description":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75978","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81333","name":"Tgfbi gene common variants","description":"Tgfbi (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, r124h, r124c, r124l, r555w, r555q)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31084","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57105","name":"Biopsy vaginal mucosa xtnsv","description":"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67031","name":"Laser surgery eye strands","description":"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33286","name":"Rmvl subq car rhythm mntr","description":"Removal, subcutaneous cardiac rhythm monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36224","name":"Place cath carotd art","description":"Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21556","name":"Exc neck tum deep < 5 cm","description":"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82088","name":"Assay of aldosterone","description":"Aldosterone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33390","name":"Valvuloplasty aortic valve","description":"Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; simple (ie, valvotomy, debridement, debulking, and/or simple commissural resuspension)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9507.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50360","name":"Rnl altrnsplj w/o rcp nfrct","description":"Renal allotransplantation, implantation of graft; without recipient nephrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2105.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45915","name":"Remove rectal obstruction","description":"Removal of fecal impaction or foreign body (separate procedure) under anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66930","name":"Extraction of lens","description":"Removal of lens material; intracapsular, for dislocated lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57287","name":"Revise/remove sling repair","description":"Removal or revision of sling for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0710","name":"Restraints any type","description":"Restraints, any type (body, chest, wrist or ankle)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4875.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3213","name":"Benesch boot pair child","description":"Benesch boot, pair, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29885","name":"Arthrs kne srg drlg ost diss","description":"Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0146T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521T","name":"Interrog dev eval wcs ip","description":"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23146","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15335","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33364","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open iliac artery approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99221","name":"1st hosp ip/obs sf/low 40","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. when using total time on the date of the encounter for code selection, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52450","name":"Transurethral inc prostate","description":"Transurethral incision of prostate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96405","name":"Chemo intralesional up to 7","description":"Chemotherapy administration; intralesional, up to and including 7 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74251","name":"X-ray xm sm int 2cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32701","name":"Thorax stereo rad targetw/tx","description":"Thoracic target(s) delineation for stereotactic body radiation therapy (srs/sbrt), (photon or particle beam), entire course of treatment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77012","name":"Ct scan for needle biopsy","description":"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33496","name":"Repair prosth valve clot","description":"Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23675","name":"Cltx sho dislc neck fx mnpj","description":"Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28090","name":"Removal of foot lesion","description":"Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1788","name":"Port, indwelling, imp","description":"Port, indwelling (implantable)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39000","name":"Exploration of chest","description":"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29520","name":"Strapping of hip","description":"Strapping; hip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20520","name":"Rmvl fb musc/tdn simple","description":"Removal of foreign body in muscle or tendon sheath; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66680","name":"Repair iris & ciliary body","description":"Repair of iris, ciliary body (as for iridodialysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25420","name":"Repair/graft radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21445","name":"Optx mndblr/max alv ridge fx","description":"Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484T","name":"Tmvi transthoracic exposure","description":"Transcatheter mitral valve implantation/replacement (tmvi) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58952","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction, intra-abdominal or retroperitoneal tumors)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1039.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63030","name":"Lamot dcmprn nrv rt 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":859.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88269","name":"Chromosome analys amniotic","description":"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51030","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3290.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36511","name":"Apheresis wbc","description":"Therapeutic apheresis; for white blood cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","name":"Anes insj penile prosthesis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44402","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576T","name":"Interrog dev eval icds ss ip","description":"Interrogation device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52500","name":"Trurl resection bladder neck","description":"Transurethral resection of bladder neck (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31294","name":"Nsl/sins ndsc surg on dcmprn","description":"Nasal/sinus endoscopy, surgical, with optic nerve decompression","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78432","name":"Myocrd img pet 2rtracer","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2170.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88309","name":"Tissue exam by pathologist","description":"Level vi - surgical pathology, gross and microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection extremity, disarticulation fetus, with dissection larynx, partial/total resect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2411.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51840","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1803.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26591","name":"Repair muscles of hand","description":"Repair, intrinsic muscles of hand, each muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73502","name":"X-ray exam hip uni 2-3 views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43410","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9981","name":"Remote e/m new pt 45mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1412.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521T","name":"Interrog dev eval wcs ip","description":"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560T","name":"Antmc mdl 3d print ea addl","description":"Anatomic model 3d-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12002","name":"Rpr s/n/ax/gen/trnk2.6-7.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99239","name":"Hosp ip/obs dschrg mgmt >30","description":"Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86341","name":"Islet cell antibody","description":"Islet cell antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44376","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77785","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64417","name":"Njx aa&/strd ax nerve img","description":"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93282","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95980","name":"Io anal gast n-stim init","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64581","name":"Opn impltj nea sacral nerve","description":"Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27513","name":"Treatment of thigh fracture","description":"Open treatment of femoral supracondylar or transcondylar fracture with intercondylar extension, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50694","name":"Plmt ureteral stent prq","description":"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82232","name":"Assay of beta-2 protein","description":"Beta-2 microglobulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88313","name":"Special stains group 2","description":"Special stain including interpretation and report; group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94727","name":"Gas dil/wshot deter lng vol","description":"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93624","name":"Ep f-up study pacg&rec","description":"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35511","name":"Art byp grft subclav-subclav","description":"Bypass graft, with vein; subclavian-subclavian","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":783.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36005","name":"Injection ext venography","description":"Injection procedure for extremity venography (including introduction of needle or intracatheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50770","name":"Splicing of ureters","description":"Transureteroureterostomy, anastomosis of ureter to contralateral ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36416","name":"Collj capillary blood spec","description":"Collection of capillary blood specimen (eg, finger, heel, ear stick)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84402","name":"Assay of free testosterone","description":"Testosterone; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21295","name":"Revision of jaw muscle/bone","description":"Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); extraoral approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68330","name":"Revise eyelid lining","description":"Repair of symblepharon; conjunctivoplasty, without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26428","name":"Repair/graft finger tendon","description":"Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); with free graft (includes obtaining graft), each finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2757.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40510","name":"Partial excision of lip","description":"Excision of lip; transverse wedge excision with primary closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42000","name":"Drainage mouth roof lesion","description":"Drainage of abscess of palate, uvula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90947","name":"Dialysis repeated eval","description":"Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies) requiring repeated evaluations by a physician or other qualified health care professional, with or without substantial revision of dialysis prescription","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82642","name":"Dihydrotestosterone","description":"Dihydrotestosterone (dht)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87850","name":"N. gonorrhoeae assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; neisseria gonorrhoeae","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64566","name":"Neuroeltrd stim post tibial","description":"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32605","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88121","name":"Cytp urine 3-5 probes cmptr","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82928","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65860","name":"Severing ads ant sgm laser","description":"Severing adhesions of anterior segment, laser technique (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95922","name":"Autonomic nrv adrenrg inervj","description":"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84392","name":"Assay of urine sulfate","description":"Sulfate, urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0249T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49082","name":"Abd paracentesis","description":"Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0124","name":"Screen c/v thin layer by md","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6005","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44376","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2492.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50660","name":"Removal of ureter","description":"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88312","name":"Special stains group 1","description":"Special stain including interpretation and report; group i for microorganisms (eg, acid fast, methenamine silver)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95925","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21558","name":"Resect neck tumor 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559T","name":"Antmc mdl 3d print 1st cmpnt","description":"Anatomic model 3d-printed from image data set(s); first individually prepared and processed component of an anatomic structure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43755","name":"Dx gastr intub w/asp specs","description":"Gastric intubation and aspiration, diagnostic; collection of multiple fractional specimens with gastric stimulation, single or double lumen tube (gastric secretory study) (eg, histamine, insulin, pentagastrin, calcium, secretin), includes drug administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44207","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1476.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49080","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1572.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83080","name":"Assay of b hexosaminidase ea","description":"B-hexosaminidase, each assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7274","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27111","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to femoral neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6412","name":"Occlusive eye patch","description":"Eye patch, occlusive, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96119","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47550","name":"Bile duct endoscopy add-on","description":"Biliary endoscopy, intraoperative (choledochoscopy) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23101","name":"Arthrt acrmclv/strnclav jt","description":"Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6524.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26415","name":"Excision hand/finger tendon","description":"Excision of extensor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30115","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), extensive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5266","name":"Battery for hearing device","description":"Battery for use in hearing device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82387","name":"Assay of cathepsin-d","description":"Cathepsin-d","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4197","name":"Parenteral sol 74-100 gm pro","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1545.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","name":"Scr mammo bi incl cad","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92601","name":"Cochlear implt f/up exam <7","description":"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20912","name":"Remove cartilage for graft","description":"Cartilage graft; nasal septum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54405","name":"Insert multi-comp penis pros","description":"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46948","name":"Int hrhc tranal dartlzj 2+","description":"Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73219","name":"Mri upper extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31081","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42650","name":"Dilation of salivary duct","description":"Dilation salivary duct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71271","name":"Ct thorax lung cancer scr c-","description":"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","name":"Anes xtrprtl lwr abd rnl px","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69100","name":"Biopsy of external ear","description":"Biopsy external ear","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26497","name":"Finger tendon transfer","description":"Transfer of tendon to restore intrinsic function; ring and small finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36221","name":"Place cath thoracic aorta","description":"Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0314","name":"Counsel immune <21 16-30 m","description":"Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 16-30 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378T","name":"Visual field assmnt rev/rprt","description":"Visual field assessment, with concurrent real time data analysis and accessible data storage with patient initiated data transmitted to a remote surveillance center for up to 30 days; review and interpretation with report by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22905","name":"Rad resect abd tumor 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19260","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","name":"Anes thrcm px pulm rescj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62143","name":"Rpl b1 flp/prostc plate skl","description":"Replacement of bone flap or prosthetic plate of skull","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35491","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28725","name":"Arthrodesis subtalar","description":"Arthrodesis; subtalar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77326","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2492.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50700","name":"Revision of ureter","description":"Ureteroplasty, plastic operation on ureter (eg, stricture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28436","name":"Prq skel fix talus fx w/mnpj","description":"Percutaneous skeletal fixation of talus fracture, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23585","name":"Optx scapular fx w/int fixj","description":"Open treatment of scapular fracture (body, glenoid or acromion) includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82480","name":"Assay serum cholinesterase","description":"Cholinesterase; serum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34708","name":"Evasc rpr ilio-iliac rpt","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1620.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75978","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67042","name":"Vit for macular hole","description":"Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23616","name":"Optx prx hmrl fx fix rpr rpl","description":"Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; with proximal humeral prosthetic replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83003","name":"Assay growth hormone (hgh)","description":"Growth hormone, human (hgh) (somatotropin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51530","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57100","name":"Biopsy vaginal mucosa simple","description":"Biopsy of vaginal mucosa; simple (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43825","name":"Gastrojejunostomy w/vagotomy","description":"Gastrojejunostomy; with vagotomy, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57105","name":"Biopsy vaginal mucosa xtnsv","description":"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63283","name":"Bx/exc idrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1736.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99367","name":"Team conf w/o pat by phys","description":"Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76814","name":"Ob us nuchal meas add-on","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49491","name":"Rpr hern preemie reduc","description":"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58210","name":"Extensive hysterectomy","description":"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"Home/res vst est high mdm 60","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50546","name":"Laparoscopic nephrectomy","description":"Laparoscopy, surgical; nephrectomy, including partial ureterectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74178","name":"Ct abd&plv wo cntr flwd cntr","description":"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2910.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22210","name":"Incis 1 vertebral seg cerv","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95872","name":"Ndl emg single fiber eltrd","description":"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":248.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4100","name":"Food thickener oral","description":"Food thickener, administered orally, per ounce","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0641","name":"Multi-position stnd fram sys","description":"Standing frame/table system, multi-position (e.g., three-way stander), any size including pediatric, with or without wheels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78465","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1895.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83905","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59076","name":"Fetal shunt placement w/us","description":"Fetal shunt placement, including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61312","name":"Crnec/crnot sttl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87475","name":"Lyme dis dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia burgdorferi, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87640","name":"Staph a dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); staphylococcus aureus, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27730","name":"Repair of tibia epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88271","name":"Cytogenetics dna probe","description":"Molecular cytogenetics; dna probe, each (eg, fish)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62269","name":"Needle biopsy spinal cord","description":"Biopsy of spinal cord, percutaneous needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21615","name":"Excision 1st &/cervical rib","description":"Excision first and/or cervical rib;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50815","name":"Urine shunt to intestine","description":"Ureterocolon conduit, including intestine anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87807","name":"Rsv assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0091","name":"Obtaining screen pap smear","description":"Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0309","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21401","name":"Closed tx orbit w/manipulj","description":"Closed treatment of fracture of orbit, except blowout; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2243.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35820","name":"Explore chest vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; chest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0283","name":"Elec stim other than wound","description":"Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20101","name":"Expl pentrg wound chest","description":"Exploration of penetrating wound (separate procedure); chest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72083","name":"X-ray exam entire spi 4/5 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86038","name":"Antinuclear antibodies","description":"Antinuclear antibodies (ana);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28470","name":"Cltx metatarsal fx wo mnp ea","description":"Closed treatment of metatarsal fracture; without manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27000","name":"Tenotomy adductor hip perq","description":"Tenotomy, adductor of hip, percutaneous (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20100","name":"Expl pentrg wound neck","description":"Exploration of penetrating wound (separate procedure); neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43262","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with sphincterotomy/papillotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4290","name":"Sacral nerve stim test lead","description":"Sacral nerve stimulation test lead, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26508","name":"Release thumb contracture","description":"Release of thenar muscle(s) (eg, thumb contracture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22840","name":"Insert spine fixation device","description":"Posterior non-segmental instrumentation (eg, harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at c1, facet screw fixation) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64790","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; major peripheral nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41115","name":"Excision of tongue fold","description":"Excision of lingual frenum (frenectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27328","name":"Exc thigh/knee tum deep <5cm","description":"Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26045","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); open, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27345","name":"Removal of knee cyst","description":"Excision of synovial cyst of popliteal space (eg, bakers cyst)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44150","name":"Removal of colon","description":"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1532.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42961","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29860","name":"Hip arthroscopy dx","description":"Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15170","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83060","name":"Hgb sulfhemoglobin quan","description":"Hemoglobin; sulfhemoglobin, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23450","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; putti-platt procedure or magnuson type operation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85410","name":"Fibrinolytic antiplasmin","description":"Fibrinolytic factors and inhibitors; alpha-2 antiplasmin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31086","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61781","name":"Scan proc cranial intra","description":"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15946","name":"Exc isch pr ulc prep mus flp","description":"Excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or myocutaneous flap or skin graft closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21510","name":"Inc deep opng b1 crtx thorax","description":"Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), thorax","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49320","name":"Diag laparo separate proc","description":"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77001","name":"Fluoroguide for vein device","description":"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic su","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14418.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20611","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26590","name":"Repair finger deformity","description":"Repair macrodactylia, each digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0447","name":"Behavior counsel obesity 15m","description":"Face-to-face behavioral counseling for obesity, 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93631","name":"Ntraop epicar&endcar pac&map","description":"Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62160","name":"Neuroendoscopy add-on","description":"Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27275","name":"Manipulation of hip joint","description":"Manipulation, hip joint, requiring general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64804","name":"Sympathectomy cervicothorac","description":"Sympathectomy, cervicothoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1075.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35231","name":"Repair blvsl vn grf neck","description":"Repair blood vessel with vein graft; neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44389","name":"Colonoscopy with biopsy","description":"Colonoscopy through stoma; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64493","name":"Inj paravert f jnt l/s 1 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74340","name":"X-ray guide for gi tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott), including multiple fluoroscopies and images, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0761","name":"Nontherm electromgntc device","description":"Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21079","name":"Impres&prep intrm obt prosth","description":"Impression and custom preparation; interim obturator prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1206.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37766","name":"Phleb veins - extrem 20+","description":"Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92082","name":"Intermediate visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on goldmann perimeter, or semiquantitative, automated suprathreshold screening program, humphrey suprathreshold automatic diagnostic test, octopus program 33)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2531.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38770","name":"Remove pelvis lymph nodes","description":"Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87250","name":"Virus inoculate eggs/animal","description":"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4663","name":"Dialysis blood pressure cuff","description":"Blood pressure cuff only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87280","name":"Respiratory syncytial ag if","description":"Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34510","name":"Transposition of vein valve","description":"Venous valve transposition, any vein donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90810","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01230","name":"Anes opn upper 2/3 femur nos","description":"Anesthesia for open procedures involving upper two-thirds of femur; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78266","name":"Gstr empt img sm bwl&colon","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24130","name":"Excision radial head","description":"Excision, radial head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52700","name":"Drainage of prostate abscess","description":"Transurethral drainage of prostatic abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9488","name":"Remote e/m est. pt 25mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of modera","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42842","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15783","name":"Dermabrasion suprfl any site","description":"Dermabrasion; superficial, any site (eg, tattoo removal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278T","name":"Tempr","description":"Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31292","name":"Nsl/sins ndsc med/inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial or inferior wall","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87561","name":"M.avium-intra dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5577.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45905","name":"Dilation of anal sphincter","description":"Dilation of anal sphincter (separate procedure) under anesthesia other than local","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50290","name":"Excision perinephric cyst","description":"Excision of perinephric cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","name":"Anes thoracotomy px nos","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81164","name":"Brca1&2 gen ful dup/del alys","description":"Brca1 (brca1, dna repair associated), brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2789.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69717","name":"Rplcmt oi implt skl prq esp","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96521","name":"Refill/maint portable pump","description":"Refilling and maintenance of portable pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75774","name":"Artery x-ray each vessel","description":"Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43269","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93539","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53440","name":"Male sling procedure","description":"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49560","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1220.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24332","name":"Tenolysis triceps","description":"Tenolysis, triceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0248T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26562","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; complex (eg, involving bone, nails)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35533","name":"Art byp grft axill/fem/fem","description":"Bypass graft, with vein; axillary-femoral-femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1331.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73706","name":"Ct angio lwr extr w/o&w/dye","description":"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33224","name":"Insert pacing lead & connect","description":"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, with attachment to previously placed pacemaker or implantable defibrillator pulse generator (including revision of pocket, removal, insertion, and/or replacement of existing generator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92617","name":"Fees w/laryngeal sense i&r","description":"Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77432","name":"Stereotactic radiation trmt","description":"Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92588","name":"Evoked auditory tst complete","description":"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29826","name":"Sho arthrs srg decompression","description":"Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) release, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81312","name":"Pabpn1 gene detc abnor allel","description":"Pabpn1 (poly[a] binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":219.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2756.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26489","name":"Transplant/graft palm tendon","description":"Transfer or transplant of tendon, palmar; with free tendon graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92971","name":"Cardioassist external","description":"Cardioassist-method of circulatory assist; external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61760","name":"Implant brain electrodes","description":"Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1442.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3952.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33945","name":"Transplantation of heart","description":"Heart transplant, with or without recipient cardiectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01935","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81306","name":"Nudt15 gene common variants","description":"Nudt15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","name":"Neuraxl lbr anes vag dlvr","description":"Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64913","name":"Nrv rpr w/nrv algrft ea addl","description":"Nerve repair; with nerve allograft, each additional strand (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58400","name":"Suspension of uterus","description":"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96110","name":"Developmental screen w/score","description":"Developmental screening (eg, developmental milestone survey, speech and language delay screen), with scoring and documentation, per standardized instrument","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78351","name":"Bone mineral dual photon","description":"Bone density (bone mineral content) study, 1 or more sites; dual photon absorptiometry, 1 or more sites","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83866","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75671","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31614","name":"Tracheostoma revj complex","description":"Tracheostoma revision; complex, with flap rotation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1809.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92982","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36640","name":"Insertion catheter artery","description":"Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23625","name":"Cltx gr hmrl tbrs fx w/mnpj","description":"Closed treatment of greater humeral tuberosity fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1748.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80074","name":"Acute hepatitis panel","description":"Acute hepatitis panel this panel must include the following: hepatitis a antibody (haab), igm antibody (86709) hepatitis b core antibody (hbcab), igm antibody (86705) hepatitis b surface antigen (hbsag) (87340) hepatitis c antibody (86803)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0812","name":"Power operated vehicle noc","description":"Power operated vehicle, not otherwise classified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"Psytx w pt 30 minutes","description":"Psychotherapy, 30 minutes with patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83018","name":"Heavy metal quan each nes","description":"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26548","name":"Reconstruct finger joint","description":"Repair and reconstruction, finger, volar plate, interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49525","name":"Repair ing hernia sliding","description":"Repair inguinal hernia, sliding, any age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84410","name":"Testosterone bioavailable","description":"Testosterone; bioavailable, direct measurement (eg, differential precipitation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1366.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36217","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8035.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87164","name":"Dark field exam spec collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69310","name":"Rebuild outer ear canal","description":"Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78460","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75574","name":"Ct angio hrt w/3d image","description":"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78453","name":"Ht muscle image planar sing","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44388","name":"Colonoscopy thru stoma spx","description":"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84275","name":"Assay of sialic acid","description":"Sialic acid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70554","name":"Fmri brain by tech","description":"Magnetic resonance imaging, brain, functional mri; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27197","name":"Clsd tx pelvic ring fx","description":"Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; without","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27334","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior or posterior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23630","name":"Optx gr hmrl tbrs fx int fix","description":"Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45116","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; transsacral approach only (kraske type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96932","name":"Rcm img acquisj only 1st les","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition only, first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82696","name":"Assay of etiocholanolone","description":"Etiocholanolone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21932","name":"Exc back tum deep < 5 cm","description":"Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80170","name":"Assay of gentamicin","description":"Gentamicin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27412","name":"Autochondrocyte implant knee","description":"Autologous chondrocyte implantation, knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61886","name":"Implant neurostim arrays","description":"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0638","name":"Standing frame sys","description":"Standing frame/table system, one position (e.g., upright, supine or prone stander), any size including pediatric, with or without wheels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82136","name":"Amino acids quant 2-5","description":"Amino acids, 2 to 5 amino acids, quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5330.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81596","name":"Nfct ds chrnc hcv 6 assays","description":"Infectious disease, chronic hepatitis c virus (hcv) infection, six biochemical assays (alt, a2-macroglobulin, apolipoprotein a-1, total bilirubin, ggt, and haptoglobin) utilizing serum, prognostic algorithm reported as scores for fibrosis and necroinflammatory activity in liver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7300.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27566","name":"Treat kneecap dislocation","description":"Open treatment of patellar dislocation, with or without partial or total patellectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45300","name":"Proctosigmoidoscopy dx","description":"Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3212","name":"Benesch boot pair infant","description":"Benesch boot, pair, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45150","name":"Excision of rectal stricture","description":"Division of stricture of rectum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33988","name":"Insertion of left heart vent","description":"Insertion of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ecmo/ecls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64595","name":"Rev/rmv prph sac/gstr npg/r","description":"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71022","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3911","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80422","name":"Glucagon tolerance panel","description":"Glucagon tolerance panel; for insulinoma this panel must include the following: glucose (82947 x 3) insulin (83525 x 3)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32672","name":"Thoracoscopy for lvrs","description":"Thoracoscopy, surgical; with resection-plication for emphysematous lung (bullous or non-bullous) for lung volume reduction (lvrs), unilateral includes any pleural procedure, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5020","name":"Conformity evaluation","description":"Conformity evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20962","name":"Other bone graft microvasc","description":"Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2254.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27730","name":"Repair of tibia epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74712","name":"Mri fetal sngl/1st gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26121","name":"Release palm contracture","description":"Fasciectomy, palm only, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23515","name":"Optx clavicular fx w/int fix","description":"Open treatment of clavicular fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28088","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; extensor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92242","name":"Fluorescein&icg angiography","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9187","name":"Bpci home visit","description":"Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/managemen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29822","name":"Sho arthrs srg lmtd dbrdmt","description":"Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97602","name":"Wound(s) care non-selective","description":"Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP03","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67923","name":"Repair eyelid defect","description":"Repair of entropion; excision tarsal wedge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54901","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11402","name":"Exc tr-ext b9+marg 1.1-2 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85240","name":"Clot factor viii ahg 1 stage","description":"Clotting; factor viii (ahg), 1-stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","name":"Anes cardiac catheterization","description":"Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include swan-ganz catheter)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86367","name":"Stem cells total count","description":"Stem cells (ie, cd34), total count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63252","name":"Revise spine cord vsl thrlmb","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2801.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50380","name":"Rnl autotrnsplj rimpltj kdn","description":"Renal autotransplantation, reimplantation of kidney","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1753.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11643","name":"Exc f/e/e/n/l mal+mrg 2.1-3","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58925","name":"Removal of ovarian cyst(s)","description":"Ovarian cystectomy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42725","name":"I&d absc phrngl xtrnl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28505","name":"Treat big toe fracture","description":"Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22862","name":"Rev rplcm rthrp 1ntrspc lmbr","description":"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2116.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27602","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89225","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30130","name":"Excise inferior turbinate","description":"Excision inferior turbinate, partial or complete, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57513","name":"Laser surgery of cervix","description":"Cautery of cervix; laser ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17110","name":"Destruction b9 les up to 14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26105","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; metacarpophalangeal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76950","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27400","name":"Revise thigh muscles/tendons","description":"Transfer, tendon or muscle, hamstrings to femur (eg, eggers type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26055","name":"Incise finger tendon sheath","description":"Tendon sheath incision (eg, for trigger finger)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46735","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1901.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43264","name":"Ercp remove duct calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of calculi/debris from biliary/pancreatic duct(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68400","name":"I&d lacrimal gland","description":"Incision, drainage of lacrimal gland","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20950","name":"Mntr intrstitial fluid press","description":"Monitoring of interstitial fluid pressure (includes insertion of device, eg, wick catheter technique, needle manometer technique) in detection of muscle compartment syndrome","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55040","name":"Removal of hydrocele","description":"Excision of hydrocele; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474T","name":"Insj aqueous drg dev io rsvr","description":"Insertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29867","name":"Allgrft implnt knee w/scope","description":"Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64640","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; other peripheral nerve or branch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80158","name":"Drug assay cyclosporine","description":"Cyclosporine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0250","name":"Md inr test revie inter mgmt","description":"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of servic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25110","name":"Remove wrist tendon lesion","description":"Excision, lesion of tendon sheath, forearm and/or wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68135","name":"Destruction les conjunctiva","description":"Destruction of lesion, conjunctiva","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86674","name":"Giardia lamblia antibody","description":"Antibody; giardia lamblia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90807","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82805","name":"Blood gases w/o2 saturation","description":"Gases, blood, any combination of ph, pco2, po2, co2, hco3 (including calculated o2 saturation); with o2 saturation, by direct measurement, except pulse oximetry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84436","name":"Assay of total thyroxine","description":"Thyroxine; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2341.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74183","name":"Mri abd w/o cntr flwd cntr","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47360","name":"Repair liver wound","description":"Management of liver hemorrhage; complex suture of liver wound or injury, with or without hepatic artery ligation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50728","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70470","name":"Ct head/brain w/o & w/dye","description":"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76536","name":"Us exam of head and neck","description":"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47000","name":"Needle biopsy of liver perq","description":"Biopsy of liver, needle; percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45120","name":"Removal of rectum","description":"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull-through procedure and anastomosis (eg, swenson, duhamel, or soave type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27266","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38215","name":"Harvest stem cell concentrte","description":"Transplant preparation of hematopoietic progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68510","name":"Biopsy of tear gland","description":"Biopsy of lacrimal gland","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","name":"Anes arthr/ndsc tot wrst rpl","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28302","name":"Incision of ankle bone","description":"Osteotomy; talus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28113","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; fifth metatarsal head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58100","name":"Biopsy of uterus lining","description":"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30110","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2015","name":"Post-d/c care plan overs 60m","description":"Comprehensive (60 mins) home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9488","name":"Remote e/m est. pt 25mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of modera","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0427","name":"Inpt/ed teleconsult70","description":"Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86590","name":"Streptokinase antibody","description":"Streptokinase, antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44701","name":"Intraop colon lavage add-on","description":"Intraoperative colonic lavage (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93229","name":"Remote 30 day ecg tech supp","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83704","name":"Lipoprotein bld quan part","description":"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53260","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral polyp(s), distal urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47540","name":"Perq plmt bile duct stent","description":"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; new access,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","name":"Anes px nrv msc upr a&e tnot","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74240","name":"X-ray xm upr gi trc 1cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96369","name":"Sc ther infusion up to 1 hr","description":"Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); initial, up to 1 hour, including pump set-up and establishment of subcutaneous infusion site(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35656","name":"Bpg femoral-popliteal","description":"Bypass graft, with other than vein; femoral-popliteal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84302","name":"Assay of sweat sodium","description":"Sodium; other source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0430","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28298","name":"Cor hlx vlgs prx phlx osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83518","name":"Immunoassay dipstick","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63655","name":"Implant neuroelectrodes","description":"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67906","name":"Repair eyelid defect","description":"Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25924","name":"Amputation follow-up surgery","description":"Disarticulation through wrist; re-amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80426","name":"Gonadotropin hormone panel","description":"Gonadotropin releasing hormone stimulation panel this panel must include the following: follicle stimulating hormone (fsh) (83001 x 4) luteinizing hormone (lh) (83002 x 4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0013A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37617","name":"Ligation major artery abd","description":"Ligation, major artery (eg, post-traumatic, rupture); abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50593","name":"Perc cryo ablate renal tum","description":"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57550","name":"Removal of residual cervix","description":"Excision of cervical stump, vaginal approach;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74247","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21049","name":"Excis uppr jaw cyst w/repair","description":"Excision of benign tumor or cyst of maxilla; requiring extra-oral osteotomy and partial maxillectomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57250","name":"Repair rectum & vagina","description":"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80170","name":"Assay of gentamicin","description":"Gentamicin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1587.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82554","name":"Creatine isoforms","description":"Creatine kinase (ck), (cpk); isoforms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95720","name":"Eeg phy/qhp ea incr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of eeg recording, interpretation and report after each 24-hour period; w","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49585","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33536","name":"Cabg arterial four or more","description":"Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2297.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41005","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95967","name":"Meg evoked each addl","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86413","name":"Sars-cov-2 antb quantitative","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) antibody, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37234","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95990","name":"Spin/brain pump refil & main","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP18","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33226","name":"Reposition l ventric lead","description":"Repositioning of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion and/or replacement of existing generator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7261","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1777.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57423","name":"Repair paravag defect lap","description":"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3966.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78815","name":"Pet image w/ct skull-thigh","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; skull base to mid-thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15832","name":"Exc excessive skin thigh","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92652","name":"Aep thrshld est mlt freq i&r","description":"Auditory evoked potentials; for threshold estimation at multiple frequencies, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45320","name":"Proctosigmoidoscopy ablate","description":"Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (eg, laser)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82016","name":"Acylcarnitines qual","description":"Acylcarnitines; qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17312","name":"Mohs addl stage","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), h","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72082","name":"X-ray exam entire spi 2/3 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24505","name":"Cltx humrl shft fx w/mnpj","description":"Closed treatment of humeral shaft fracture; with manipulation, with or without skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48552","name":"Prep donor pancreas/venous","description":"Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43242","name":"Egd us fine needle bx/aspir","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65772","name":"Correction of astigmatism","description":"Corneal relaxing incision for correction of surgically induced astigmatism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2448.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7981.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64626","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77059","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87483","name":"Cns dna amp probe type 12-25","description":"Infectious agent detection by nucleic acid (dna or rna); central nervous system pathogen (eg, neisseria meningitidis, streptococcus pneumoniae, listeria, haemophilus influenzae, e. coli, streptococcus agalactiae, enterovirus, human parechovirus, herpes simplex virus type 1 and 2, human herpesvirus 6","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61790","name":"Treat trigeminal nerve","description":"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4081.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0445","name":"Oximeter non-invasive","description":"Oximeter device for measuring blood oxygen levels non-invasively","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99155","name":"Mod sed oth phys/qhp <5 yrs","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient younger th","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45000","name":"Drainage of pelvic abscess","description":"Transrectal drainage of pelvic abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0415","name":"Open tx post pelvic fxcture","description":"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77003","name":"Fluoroguide for spine inject","description":"Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36246","name":"Ins cath abd/l-ext art 2nd","description":"Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31287","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93631","name":"Ntraop epicar&endcar pac&map","description":"Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46614","name":"Anoscopy control bleeding","description":"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69740","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37761","name":"Ligate leg veins open","description":"Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33225","name":"L ventric pacing lead add-on","description":"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","name":"Anes ther ivntl rad ven nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01758","name":"Anes opn/arthrs elbw exc cst","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; excision of cyst or tumor of humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64490","name":"Inj paravert f jnt c/t 1 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98966","name":"Ph1 assmt&mgmt nqhp 5-10","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483T","name":"Tmvi percutaneous approach","description":"Transcatheter mitral valve implantation/replacement (tmvi) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86619","name":"Borrelia antibody","description":"Antibody; borrelia (relapsing fever)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50606","name":"Endoluminal bx urtr rnl plvs","description":"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01430","name":"Anes px veins knee&pop nos","description":"Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65600","name":"Revision of cornea","description":"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50370","name":"Rmvl transplanted rnl algrft","description":"Removal of transplanted renal allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1044.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1068.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2634.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5947.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65755","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in pseudophakia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1071.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64642","name":"Chemodenerv 1 extremity 1-4","description":"Chemodenervation of one extremity; 1-4 muscle(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27824","name":"Treat lower leg fracture","description":"Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27860","name":"Fixation of ankle joint","description":"Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27230","name":"Treat thigh fracture","description":"Closed treatment of femoral fracture, proximal end, neck; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","name":"Anes opn/arthr elb tot rplct","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33510","name":"Cabg vein single","description":"Coronary artery bypass, vein only; single coronary venous graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1681.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21244","name":"Reconstruction of lower jaw","description":"Reconstruction of mandible, extraoral, with transosteal bone plate (eg, mandibular staple bone plate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61888","name":"Revise/remove neuroreceiver","description":"Revision or removal of cranial neurostimulator pulse generator or receiver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93568","name":"Njx car cth nslc p-art angrp","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56631","name":"Vlvctmy rad prtl uni lymphad","description":"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70543","name":"Mri orbt/fac/nck w/o &w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21044","name":"Removal of jaw bone lesion","description":"Excision of malignant tumor of mandible;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1539.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51702","name":"Insert temp bladder cath","description":"Insertion of temporary indwelling bladder catheter; simple (eg, foley)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93572","name":"Iv dop vel&/press c flo ea","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1668.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44384","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26117","name":"Rad resect hand tumor < 3 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87802","name":"Strep b assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group b","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95967","name":"Meg evoked each addl","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33406","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with allograft valve (freehand)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81182","name":"Atxn8os gen detc abnor allel","description":"Atxn8os (atxn8 opposite strand [non-protein coding]) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93662","name":"Intracardiac ecg (ice)","description":"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2014","name":"Post-d/c care plan overs 30m","description":"Limited (30 minutes) care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81183","name":"Atxn10 gene detc abnor allel","description":"Atxn10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59614","name":"Vbac care after delivery","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1017.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27832","name":"Treat lower leg dislocation","description":"Open treatment of proximal tibiofibular joint dislocation, includes internal fixation, when performed, or with excision of proximal fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2410.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66850","name":"Removal of lens material","description":"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77435","name":"Sbrt management","description":"Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81163","name":"Brca1&2 gene full seq alys","description":"Brca1 (brca1, dna repair associated), brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31637","name":"Bronchoscopy stent add-on","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; each additional major bronchus stented (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":106.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437T","name":"Impltj synth rnfcmt abdl wal","description":"Implantation of non-biologic or synthetic implant (eg, polypropylene) for fascial reinforcement of the abdominal wall (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64616","name":"Chemodenerv musc neck dyston","description":"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43243","name":"Egd injection varices","description":"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","name":"Anes male gent compl amp pns","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); complete amputation of penis","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4045.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45393","name":"Colonoscopy w/decompression","description":"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4026.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58951","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"Home/res vst est high mdm 60","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87495","name":"Cytomeg dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35102","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving iliac vessels (common, hypogastric, external)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1657.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33472","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75685","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80185","name":"Assay of phenytoin total","description":"Phenytoin; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82634","name":"Deoxycortisol","description":"Deoxycortisol, 11-","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35533","name":"Art byp grft axill/fem/fem","description":"Bypass graft, with vein; axillary-femoral-femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1331.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93892","name":"Tcd emboli detect w/o inj","description":"Transcranial doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58572","name":"Tlh uterus over 250 g","description":"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66165","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22325","name":"Treat spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1284.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10081","name":"I&d pilonidal cyst comp","description":"Incision and drainage of pilonidal cyst; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75901","name":"Remove cva device obstruct","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99225","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","name":"Scr mammo bi incl cad","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27510","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9143","name":"Warfarin respon genetic test","description":"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72133","name":"Ct lumbar spine w/o & w/dye","description":"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86762","name":"Rubella antibody","description":"Antibody; rubella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86003","name":"Allg spec ige crude xtrc ea","description":"Allergen specific ige; quantitative or semiquantitative, crude allergen extract, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67036","name":"Removal of inner eye fluid","description":"Vitrectomy, mechanical, pars plana approach;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35482","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57415","name":"Remove vaginal foreign body","description":"Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86645","name":"Cmv antibody igm","description":"Antibody; cytomegalovirus (cmv), igm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50590","name":"Fragmenting of kidney stone","description":"Lithotripsy, extracorporeal shock wave","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29898","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27610","name":"Explore/treat ankle joint","description":"Arthrotomy, ankle, including exploration, drainage, or removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57461","name":"Conz of cervix w/scope leep","description":"Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61521","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2943.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4087","name":"Gastro/jejuno tube, std","description":"Gastrostomy/jejunostomy tube, standard, any material, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51960","name":"Revision of bladder & bowel","description":"Enterocystoplasty, including intestinal anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64565","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82943","name":"Assay of glucagon","description":"Glucagon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42281","name":"Insertion palate prosthesis","description":"Insertion of pin-retained palatal prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72197","name":"Mri pelvis w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","name":"Anes px art fem art emblc","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery embolectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","name":"Anes all px nck ndl bx thyr","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27138","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; femoral component only, with or without allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78270","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27268","name":"Cltx thigh fx w/mnpj","description":"Closed treatment of femoral fracture, proximal end, head; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28150","name":"Removal of toe","description":"Phalangectomy, toe, each toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78481","name":"Heart first pass single","description":"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40530","name":"Partial removal of lip","description":"Resection of lip, more than one-fourth, without reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4510","name":"Full length surg stocking","description":"Surgical stockings full length, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61552","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; multiple cranial sutures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87496","name":"Cytomeg dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2065.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0222T","name":"Plmt post facet implt addl","description":"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9982","name":"Remote e/m new pt 60mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55870","name":"Electroejaculation","description":"Electroejaculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9645.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45114","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; abdominal and transsacral approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1526.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36015","name":"Place catheter in artery","description":"Selective catheter placement, segmental or subsegmental pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68340","name":"Separate eyelid adhesions","description":"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20551","name":"Njx 1 tendon origin/insj","description":"Injection(s); single tendon origin/insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17312","name":"Mohs addl stage","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), h","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22902","name":"Exc abd les sc < 3 cm","description":"Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108243.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97028","name":"Ultraviolet therapy","description":"Application of a modality to 1 or more areas; ultraviolet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77403","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28531","name":"Treat sesamoid bone fracture","description":"Open treatment of sesamoid fracture, with or without internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81015","name":"Microscopic exam of urine","description":"Urinalysis; microscopic only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56606","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); each separate additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","name":"Anes px art knee&pop exc&grf","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2318.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50520","name":"Close kidney-skin fistula","description":"Closure of nephrocutaneous or pyelocutaneous fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69610","name":"Tympanic membrane repair","description":"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":255.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21820","name":"Treat sternum fracture","description":"Closed treatment of sternum fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45391","name":"Colonoscopy w/endoscope us","description":"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83055","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49465","name":"Fluoro exam of g/colon tube","description":"Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69645","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83918","name":"Organic acids total quant","description":"Organic acids; total, quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36226","name":"Place cath vertebral art","description":"Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64905","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; first stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73220","name":"Mri uppr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25922","name":"Amputate hand at wrist","description":"Disarticulation through wrist; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","name":"Anes thrc spine wo 1lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19086","name":"Bx breast add lesion mr imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including magnetic resonance guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49442","name":"Place cecostomy tube perc","description":"Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20969","name":"Bone/skin graft microvasc","description":"Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2241.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13101","name":"Cmplx rpr trunk 2.6-7.5 cm","description":"Repair, complex, trunk; 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99224","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64742","name":"Incision of facial nerve","description":"Transection or avulsion of; facial nerve, differential or complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25210","name":"Removal of wrist bone","description":"Carpectomy; 1 bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99605","name":"Mtms by pharm np 15 min","description":"Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; initial 15 minutes, new patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25365","name":"Revise radius & ulna","description":"Osteotomy; radius and ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36251","name":"Ins cath ren art 1st unilat","description":"Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and inte","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27086","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; subcutaneous tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99157","name":"Mod sed other phys/qhp ea","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; each additional 15 minutes intraservice time (list separate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0313","name":"Immunize couns < 21yr 6-30 m","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82533","name":"Total cortisol","description":"Cortisol; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64722","name":"Decompression unspec nerve","description":"Decompression; unspecified nerve(s) (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72084","name":"X-ray exam entire spi 6/> vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82104","name":"Alpha-1-antitrypsin pheno","description":"Alpha-1-antitrypsin; phenotype","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9503","name":"Tc99m medronate","description":"Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21620","name":"Ostectomy sternum partial","description":"Ostectomy of sternum, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88304","name":"Tissue exam by pathologist","description":"Level iii - surgical pathology, gross and microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque bartholins gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel t","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27532","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); with or without manipulation, with skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36012","name":"Place catheter in vein","description":"Selective catheter placement, venous system; second order, or more selective, branch (eg, left adrenal vein, petrosal sinus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"S3835","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4246","name":"Betadine/phisohex solution","description":"Betadine or phisohex solution, per pint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85292","name":"Clot factor fletcher fact","description":"Clotting; prekallikrein assay (fletcher factor assay)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92572","name":"Staggered spondaic word test","description":"Staggered spondaic word test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52001","name":"Cysto w/irrg&evac mlt clots","description":"Cystourethroscopy with irrigation and evacuation of multiple obstructing clots","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1459.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49061","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33612","name":"Repair double ventricle","description":"Repair of double outlet right ventricle with intraventricular tunnel repair; with repair of right ventricular outflow tract obstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1743.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1097.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2031.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0512","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37216","name":"Transcath stent cca w/o eps","description":"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal embolic protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26494","name":"Hand tendon/muscle transfer","description":"Opponensplasty; hypothenar muscle transfer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15130","name":"Drm agrft t/a/l 1st 100 sqcm","description":"Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27244","name":"Treat thigh fracture","description":"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant, with or without cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72159","name":"Mr angio spine w/o&w/dye","description":"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3306.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4207","name":"2 cc sterile syringe&needle","description":"Syringe with needle, sterile 2 cc, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2528.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83593","name":"Fractionation ketosteroids","description":"Ketosteroids, 17- (17-ks); fractionation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26727","name":"Treat finger fracture each","description":"Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44125","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; with enterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0145","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1608.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21137","name":"Rdctj forehead cntrg only","description":"Reduction forehead; contouring only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50220","name":"Remove kidney open","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","name":"Anes 2&3 burn 4-9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; between 4% and 9% of total body surface area","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29899","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13132","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","description":"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93590","name":"Perq transcath cls mitral","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25574","name":"Optx rdl&uln shft fx rds/uln","description":"Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius or ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2793.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53446","name":"Remove uro sphincter","description":"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4245","name":"Alcohol wipes per box","description":"Alcohol wipes, per box","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0400","name":"Home sleep test/type 4 porta","description":"Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485T","name":"Oct mid ear i&r unilateral","description":"Optical coherence tomography (oct) of middle ear, with interpretation and report; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28092","name":"Removal of toe lesions","description":"Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); toe(s), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82044","name":"Ur albumin semiquantitative","description":"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57120","name":"Colpocleisis le fort type","description":"Colpocleisis (le fort type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24076","name":"Ex arm/elbow tum deep < 5 cm","description":"Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87809","name":"Adenovirus assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43123","name":"Partial removal of esophagus","description":"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3775.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67039","name":"Laser treatment of retina","description":"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91117","name":"Colon motility 6 hr study","description":"Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40810","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86732","name":"Mucormycosis antibody","description":"Antibody; mucormycosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19271","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58561","name":"Hysteroscopy remove myoma","description":"Hysteroscopy, surgical; with removal of leiomyomata","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27393","name":"Lengthening of thigh tendon","description":"Lengthening of hamstring tendon; single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95250","name":"Cont gluc mntr phys/qhp eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professional (office) provided equipment, sensor placement, hook-up, calibration of monitor, patient training, removal of sensor, and pr","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82810","name":"Blood gases o2 sat only","description":"Gases, blood, o2 saturation only, by direct measurement, except pulse oximetry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12053","name":"Intmd rpr face/mm 5.1-7.5 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86710","name":"Influenza virus antibody","description":"Antibody; influenza virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33690","name":"Banding pulmonary artery","description":"Banding of pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90912","name":"Bfb training 1st 15 min","description":"Biofeedback training, perineal muscles, anorectal or urethral sphincter, including emg and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97036","name":"App mdlty 1+hubbrd tnk ea 15","description":"Application of a modality to 1 or more areas; hubbard tank, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15657.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93230","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72083","name":"X-ray exam entire spi 4/5 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81165","name":"Brca1 gene full seq alys","description":"Brca1 (brca1, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94667","name":"Mnpj chest wall 1st","description":"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51580","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65855","name":"Trabeculoplasty laser surg","description":"Trabeculoplasty by laser surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0399","name":"Home sleep test/type 3 porta","description":"Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97606","name":"Neg prs wnd ther dme>50 sqcm","description":"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (dme), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78122","name":"Whl bld volume determination","description":"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0239","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38746","name":"Remove thoracic lymph nodes","description":"Thoracic lymphadenectomy by thoracotomy, mediastinal and regional lymphadenectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50329","name":"Prep renal graft/ureteral","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","name":"Anes px fcl b1/skl rad surg","description":"Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35875","name":"Removal of clot in graft","description":"Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61864","name":"Implant neuroelectrde addl","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; each additional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33788","name":"Revision of pulmonary artery","description":"Reimplantation of an anomalous pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1332.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","name":"Anes opn/arthr px sho jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50525","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95992","name":"Canalith repositioning proc","description":"Canalith repositioning procedure(s) (eg, epley maneuver, semont maneuver), per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86784","name":"Trichinella antibody","description":"Antibody; trichinella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27077","name":"Resect hip tum w/innom bone","description":"Radical resection of tumor; innominate bone, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2404.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25645","name":"Optx crpl fx oth/thn scph ea","description":"Open treatment of carpal bone fracture (other than carpal scaphoid [navicular]), each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1769","name":"Guide wire","description":"Guide wire","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43647","name":"Lap impl electrode antrum","description":"Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1833.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72083","name":"X-ray exam entire spi 4/5 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43610","name":"Excision of stomach lesion","description":"Excision, local; ulcer or benign tumor of stomach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0637","name":"Combination sit to stand sys","description":"Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35681","name":"Composite byp grft pros&vein","description":"Bypass graft; composite, prosthetic and vein (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97124","name":"Massage therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35703","name":"Expl n/flwd surg lxtr art","description":"Exploration not followed by surgical repair, artery; lower extremity (eg, common femoral, deep femoral, superficial femoral, popliteal, tibial, peroneal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55040","name":"Removal of hydrocele","description":"Excision of hydrocele; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0398","name":"Home sleep test/type 2 porta","description":"Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76886","name":"Us exam infant hips static","description":"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","name":"Anes xtrprt lwr abd prst8ect","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0055T","name":"Bone srgry cmptr ct/mri imag","description":"Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on ct/mri images (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88387","name":"Macroscopic xm dsj&prep tiss","description":"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21086","name":"Impres&prep auricular prosth","description":"Impression and custom preparation; auricular prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1318.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31580","name":"Laryngoplasty laryngeal web","description":"Laryngoplasty; for laryngeal web, with indwelling keel or stent insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7929.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7916.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25145","name":"Remove forearm bone lesion","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77021","name":"Mri guidance ndl plmt rs&i","description":"Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33697","name":"Compl rpr tof w/pulm atresia","description":"Complete repair tetralogy of fallot with pulmonary atresia including construction of conduit from right ventricle to pulmonary artery and closure of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"Venipuncture cutdown 1 yr/>","description":"Venipuncture, cutdown; age 1 or over","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77079","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43850","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1520.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46262","name":"Remove in/ex hem grps w/fist","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50820","name":"Construct bowel bladder","description":"Ureteroileal conduit (ileal bladder), including intestine anastomosis (bricker operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1067.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82757","name":"Assay of semen fructose","description":"Fructose, semen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63270","name":"Excise intrspinl lesion crvl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33606","name":"Anastomosis/artery-aorta","description":"Anastomosis of pulmonary artery to aorta (damus-kaye-stansel procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34706","name":"Evasc rpr a-biiliac rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2026.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35879","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch angioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95144","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, single dose vial(s) (specify number of vials)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61623","name":"Evasc temp balo artl occ h/n","description":"Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon, concomitant neurological monitoring, and radiologic supervision and interpretation of all angiogra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8687","name":"Implt nrostm pls gen dua rec","description":"Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93454","name":"Coronary artery angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31554","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, with indwelling stent placement, age 12 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64405","name":"Njx aa&/strd gr ocpl nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29325","name":"Appl hip spica cast1&1/2","description":"Application of hip spica cast; 1 and one-half spica or both legs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84432","name":"Assay of thyroglobulin","description":"Thyroglobulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33505","name":"Repair artery w/tunnel","description":"Repair of anomalous coronary artery from pulmonary artery origin; with construction of intrapulmonary artery tunnel (takeuchi procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1799.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0246T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82525","name":"Assay of copper","description":"Copper","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28022","name":"Exploration of foot joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88162","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30450","name":"Revision of nose","description":"Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1327.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49500","name":"Rpr ing hernia init reduce","description":"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82607","name":"Vitamin b-12","description":"Cyanocobalamin (vitamin b-12);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77777","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26025","name":"Drainage of palm bursa","description":"Drainage of palmar bursa; single, bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33615","name":"Repair modified fontan","description":"Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulmonary artery (simple fontan procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1735.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67570","name":"Decompress optic nerve","description":"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93242","name":"Ext ecg>48hr<7d recording","description":"External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; recording (includes connection and initial recording)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55041","name":"Removal of hydroceles","description":"Excision of hydrocele; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3899.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27792","name":"Treatment of ankle fracture","description":"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25905","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna; open, circular (guillotine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7077.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99310","name":"Sbsq nf care high mdm 45","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8476.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92549","name":"Cdp-sot 6 cond w/i&r mct&adt","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (mct) and adaptation test (adt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64732","name":"Incision of brow nerve","description":"Transection or avulsion of; supraorbital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21296","name":"Revision of jaw muscle/bone","description":"Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); intraoral approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46740","name":"Construction of absent anus","description":"Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47380","name":"Open ablate liver tumor rf","description":"Ablation, open, of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82308","name":"Assay of calcitonin","description":"Calcitonin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19030","name":"Njx px only mam ducto/glcto","description":"Injection procedure only for mammary ductogram or galactogram","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1995.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1207.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99446","name":"Ntrprof ph1/ntrnet/ehr 5-10","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4552.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54505","name":"Biopsy of testis","description":"Biopsy of testis, incisional (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36563","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device with subcutaneous pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27715","name":"Ostpl tibfib lngth/shrt","description":"Osteoplasty, tibia and fibula, lengthening or shortening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85520","name":"Heparin assay","description":"Heparin assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95940","name":"Ionm in operatng room 15 min","description":"Continuous intraoperative neurophysiology monitoring in the operating room, one on one monitoring requiring personal attendance, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15220","name":"Fth/gft fr s/a/l 20 sq cm/<","description":"Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","name":"Anes open px lower l/a/f nos","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93279","name":"Prgrmg dev eval pm/ldls pm","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system or","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88361","name":"Tumor immunohistochem/comput","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33732","name":"Repair heart-vein defect","description":"Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59850","name":"Induced abortion 1+ njx","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42870","name":"Excision of lingual tonsil","description":"Excision or destruction lingual tonsil, any method (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1852.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28420","name":"Optx calcaneal fx w/bone grf","description":"Open treatment of calcaneal fracture, includes internal fixation, when performed; with primary iliac or other autogenous bone graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97036","name":"App mdlty 1+hubbrd tnk ea 15","description":"Application of a modality to 1 or more areas; hubbard tank, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78431","name":"Myocrd img pet rst&strs ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96004","name":"Phys review of motion tests","description":"Review and interpretation by physician or other qualified health care professional of comprehensive computer-based motion analysis, dynamic plantar pressure measurements, dynamic surface electromyography during walking or other functional activities, and dynamic fine wire electromyography, with writ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72148","name":"Mri lumbar spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76496","name":"Unlisted fluoroscopic px","description":"Unlisted fluoroscopic procedure (eg, diagnostic, interventional)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33274","name":"Tcat insj/rpl perm ldls pm","description":"Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64795","name":"Biopsy of nerve","description":"Biopsy of nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99374","name":"Home health care supervision","description":"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, alzheimers facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76936","name":"Echo guide for artery repair","description":"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44388","name":"Colonoscopy thru stoma spx","description":"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61535","name":"Remove brain electrodes","description":"Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27475","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); distal femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61520","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3410.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42600","name":"Closure of salivary fistula","description":"Closure salivary fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93321","name":"Doppler echo f-up/lmtd std","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35634","name":"Bpg iliorenal","description":"Bypass graft, with other than vein; iliorenal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1564.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95716","name":"Veeg ea 12-26hr cont mntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75676","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92071","name":"Contact lens fitting for tx","description":"Fitting of contact lens for treatment of ocular surface disease","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67028","name":"Injection eye drug","description":"Intravitreal injection of a pharmacologic agent (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33684","name":"Clsr 1 vsd w/wo patch w/vlvt","description":"Closure of single ventricular septal defect, with or without patch; with pulmonary valvotomy or infundibular resection (acyanotic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1643.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44602","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33746","name":"Tis cgen car anomal ea addl","description":"Transcatheter intracardiac shunt (tis) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35473","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2273.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87636","name":"Sarscov2 & inf a&b amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b, multiplex amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21936","name":"Resect back tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1220.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87495","name":"Cytomeg dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35454","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35515","name":"Art byp grft subclav-vertbrl","description":"Bypass graft, with vein; subclavian-vertebral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62145","name":"Repair of skull & brain","description":"Cranioplasty for skull defect with reparative brain surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1297.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24400","name":"Osteot humerus w/wo int fixj","description":"Osteotomy, humerus, with or without internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86735","name":"Mumps antibody","description":"Antibody; mumps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1125.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29530","name":"Strapping of knee","description":"Strapping; knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87166","name":"Dark field exam w/o collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27760","name":"Cltx medial ankle fx","description":"Closed treatment of medial malleolus fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2313.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1978.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0339","name":"Robot lin-radsurg com, first","description":"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2583.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27253","name":"Treat hip dislocation","description":"Open treatment of hip dislocation, traumatic, without internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44208","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1603.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55845","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1104.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38230","name":"Bone marrow harvest allogen","description":"Bone marrow harvesting for transplantation; allogeneic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]},{"negotiated_type":"negotiated","negotiated_rate":307.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80162","name":"Assay of digoxin total","description":"Digoxin; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61618","name":"Repair dura","description":"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lata, adipose tissue, homologous or synthetic grafts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82715","name":"Assay of fecal fat","description":"Fat differential, feces, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22525","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3567.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9042","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77406","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41251","name":"Repair tongue laceration","description":"Repair of laceration 2.5 cm or less; posterior one-third of tongue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35189","name":"Rpr acq av fistula thrx&abd","description":"Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20838","name":"Replantation foot complete","description":"Replantation, foot, complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2367.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11597.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":7917.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88333","name":"Path consltj surg cyto xm 1","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23552","name":"Optx acrclv dslc aq/chrn grf","description":"Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56605","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); 1 lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93510","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72157","name":"Mri chest spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53620","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21154","name":"Rcnstj mdfc lefort iii w/o i","description":"Reconstruction midface, lefort iii (extracranial), any type, requiring bone grafts (includes obtaining autografts); without lefort i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1592.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50543","name":"Laparo partial nephrectomy","description":"Laparoscopy, surgical; partial nephrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76826","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0320","name":"Two-way audio and video hhs","description":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36481","name":"Insertion of catheter vein","description":"Percutaneous portal vein catheterization by any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1548.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39503","name":"Repair of diaphragm hernia","description":"Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":461.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62320","name":"Njx interlaminar crv/thrc","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85247","name":"Clot factor viii multimetric","description":"Clotting; factor viii, von willebrand factor, multimetric analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24075","name":"Exc arm/elbow les sc < 3 cm","description":"Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23000","name":"Rmvl sbdltd clcreous dep opn","description":"Removal of subdeltoid calcareous deposits, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43320","name":"Fuse esophagus & stomach","description":"Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal or transthoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52330","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46707","name":"Repair anorectal fist w/plug","description":"Repair of anorectal fistula with plug (eg, porcine small intestine submucosa [sis])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82963","name":"Assay of glucosidase","description":"Glucosidase, beta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57426","name":"Revise prosth vag graft lap","description":"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44390","name":"Colonoscopy for foreign body","description":"Colonoscopy through stoma; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11760","name":"Repair of nail bed","description":"Repair of nail bed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85390","name":"Fibrinolysins screen i&r","description":"Fibrinolysins or coagulopathy screen, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21330","name":"Open tx nose fx w/skele fixj","description":"Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77300","name":"Radiation therapy dose plan","description":"Basic radiation dosimetry calculation, central axis depth dose calculation, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28825","name":"Partial amputation of toe","description":"Amputation, toe; interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65112","name":"Remove eye/revise socket","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36566","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; with subcutaneous port(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25040","name":"Arthrt rdcrpl/midcarpl jt","description":"Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9021","name":"Red blood cells unit","description":"Red blood cells, each unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74249","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22102","name":"Remove part lumbar vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71023","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43248","name":"Egd guide wire insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33722","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1414.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","name":"Anes art f/arm wrst&hnd nos","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61796","name":"Srs cranial lesion simple","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","name":"Anes male gent rad orch ing","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33322","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27475","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); distal femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67500","name":"Inject/treat eye socket","description":"Retrobulbar injection; medication (separate procedure, does not include supply of medication)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61330","name":"Dcmprn orbit only transcrnl","description":"Decompression of orbit only, transcranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1638.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21385","name":"Opn tx orbit fx transantral","description":"Open treatment of orbital floor blowout fracture; transantral approach (caldwell-luc type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82180","name":"Assay of ascorbic acid","description":"Ascorbic acid (vitamin c), blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01931","name":"Anes ivnt rad ntrhpt/prt crc","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrahepatic or portal circulation (eg, transvenous intrahepatic portosystemic shunt[s] [tips])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23071","name":"Exc shoulder les sc 3 cm/>","description":"Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33871","name":"Transvrs a-arch grf hypthrm","description":"Transverse aortic arch graft, with cardiopulmonary bypass, with profound hypothermia, total circulatory arrest and isolated cerebral perfusion with reimplantation of arch vessel(s) (eg, island pedicle or individual arch vessel reimplantation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2854.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50400","name":"Revision of kidney/ureter","description":"Pyeloplasty (foley y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57310","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27781","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77001","name":"Fluoroguide for vein device","description":"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic su","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37241","name":"Vasc embolize/occlude venous","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1341.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77771","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2182.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27610","name":"Explore/treat ankle joint","description":"Arthrotomy, ankle, including exploration, drainage, or removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76706","name":"Us abdl aorta screen aaa","description":"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (aaa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82553","name":"Creatine mb fraction","description":"Creatine kinase (ck), (cpk); mb fraction only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87485","name":"Chlmyd pneum dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93976","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4185","name":"Pn soln nos 10 grams lipids","description":"Parenteral nutrition solution, not otherwise specified, 10 grams lipids","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90656","name":"Iiv3 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88162","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69155","name":"Extensive ear/neck surgery","description":"Radical excision external auditory canal lesion; with neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1325.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33211","name":"Insert card electrodes dual","description":"Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58120","name":"Dilation and curettage","description":"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31293","name":"Nsl/sins ndsc med&inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial and inferior wall","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27615","name":"Resect leg/ankle tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of leg or ankle area; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20251","name":"Biopsy vrt bdy open lmbr/crv","description":"Biopsy, vertebral body, open; lumbar or cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2215.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84078","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline; heat stable (total not included)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44110","name":"Excise intestine lesion(s)","description":"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21031","name":"Remove exostosis mandible","description":"Excision of torus mandibularis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69700","name":"Close mastoid fistula","description":"Closure postauricular fistula, mastoid (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75989","name":"Abscess drainage under x-ray","description":"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99408","name":"Audit/dast 15-30 min","description":"Alcohol and/or substance (other than tobacco) abuse structured screening (eg, audit, dast), and brief intervention (sbi) services; 15 to 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83861","name":"Microfluid analy tears","description":"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76826","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9868","name":"Cmmi asyntelehealth <10min","description":"Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, less than 10 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33419","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; additional prosthesis(es) during same session (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56440","name":"Mrsplzatn brthlns glnd cst","description":"Marsupialization of bartholins gland cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62165","name":"Remove pituit tumor w/scope","description":"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22010","name":"I&d p-spine c/t/cerv-thor","description":"Incision and drainage, open, of deep abscess (subfascial), posterior spine; cervical, thoracic, or cervicothoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4097","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP04","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42160","name":"Treatment mouth roof lesion","description":"Destruction of lesion, palate or uvula (thermal, cryo or chemical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95725","name":"Eeg phy/qhp>84 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of eeg recording, without video","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27727","name":"Repair of lower leg","description":"Repair of congenital pseudarthrosis, tibia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5048.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6250","name":"Skin seal protect moisturizr","description":"Skin sealants, protectants, moisturizers, ointments, any type, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"Esrd svc pr day pt 2-11","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 2-11 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97607","name":"Neg prs wnd thr ndme<=50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61534","name":"Removal of brain lesion","description":"Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42810","name":"Excision of neck cyst","description":"Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25900","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32400","name":"Needle biopsy chest lining","description":"Biopsy, pleura, percutaneous needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86648","name":"Diphtheria antibody","description":"Antibody; diphtheria","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76950","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":996.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2756.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35531","name":"Art byp grft aorcel/aormesen","description":"Bypass graft, with vein; aortoceliac or aortomesenteric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93609","name":"Intra-vntr mapg tchycar site","description":"Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15657.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6221","name":"Gauze > 48 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92977","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27520","name":"Treat kneecap fracture","description":"Closed treatment of patellar fracture, without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0145T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89140","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33025","name":"Incision of heart sac","description":"Creation of pericardial window or partial resection for drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45820","name":"Repair rectourethral fistula","description":"Closure of rectourethral fistula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43331","name":"Esophagomyotomy thoracic","description":"Esophagomyotomy (heller type); thoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3223.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4672","name":"Drainage ext line, dialysis","description":"Drainage extension line, sterile, for dialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21150","name":"Rcnstj mdfc lefrtii ant ntru","description":"Reconstruction midface, lefort ii; anterior intrusion (eg, treacher-collins syndrome)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1344.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87633","name":"Resp virus 12-25 targets","description":"Infectious agent detection by nucleic acid (dna or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26040","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1340.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27638","name":"Remove/graft leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27676","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; with fibular osteotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50760","name":"Ureteroureterostomy","description":"Ureteroureterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26776","name":"Pin finger dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92507","name":"Tx sp lang voice comm indiv","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93511","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78454","name":"Ht musc image planar mult","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93283","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantab","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29850","name":"Knee arthroscopy/surgery","description":"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27266","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11603","name":"Exc tr-ext mal+marg 2.1-3 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64913","name":"Nrv rpr w/nrv algrft ea addl","description":"Nerve repair; with nerve allograft, each additional strand (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94761","name":"N-invas ear/pls oximetry mlt","description":"Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24670","name":"Cltx ulnar fx prox w/o mnpj","description":"Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54324","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0108","name":"Diab manage trn per indiv","description":"Diabetes outpatient self-management training services, individual, per 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33989","name":"Removal of left heart vent","description":"Removal of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ecmo/ecls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0406","name":"Inpt/tele follow up 15","description":"Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21260","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96904","name":"Whole body photography","description":"Whole body integumentary photography, for monitoring of high risk patients with dysplastic nevus syndrome or a history of dysplastic nevi, or patients with a personal or familial history of melanoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95027","name":"Iq tsts seql&incrl airborne","description":"Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54348","name":"Rpr hypspad comp dsj & urtp","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39200","name":"Resect mediastinal cyst","description":"Resection of mediastinal cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99408","name":"Audit/dast 15-30 min","description":"Alcohol and/or substance (other than tobacco) abuse structured screening (eg, audit, dast), and brief intervention (sbi) services; 15 to 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88302","name":"Tissue exam by pathologist","description":"Level ii - surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incident","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99305","name":"1st nf care moderate mdm 35","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or ex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70557","name":"Mri brain w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21435","name":"Optx crnfc sep comp int&/xtr","description":"Open treatment of craniofacial separation (lefort iii type); complicated, utilizing internal and/or external fixation techniques (eg, head cap, halo device, and/or intermaxillary fixation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70496","name":"Ct angiography head","description":"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88331","name":"Path consltj surg 1 blk 1spc","description":"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99354","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92228","name":"Img rta detc/mntr ds phy/qhp","description":"Imaging of retina for detection or monitoring of disease; with remote physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00942","name":"Anes vag px clptmy vgnc clpr","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); colpotomy, vaginectomy, colporrhaphy, and open urethral procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31050","name":"Exploration sphenoid sinus","description":"Sinusotomy, sphenoid, with or without biopsy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31640","name":"Bronchoscopy w/tumor excise","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1499.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68420","name":"I&d lacrimal sac","description":"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":723.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32421","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93289","name":"Interrog device eval heart","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including anal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45330","name":"Diagnostic sigmoidoscopy","description":"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90806","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85549","name":"Muramidase","description":"Muramidase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35151","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, popliteal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1089.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78414","name":"Non-imaging heart function","description":"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69601","name":"Revj mstdc rsltg compl mstdc","description":"Revision mastoidectomy; resulting in complete mastoidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50810","name":"Fusion of ureter & bowel","description":"Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11008","name":"Rmv prstc mtrl/mesh abd wall","description":"Removal of prosthetic material or mesh, abdominal wall for infection (eg, for chronic or recurrent mesh infection or necrotizing soft tissue infection) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64550","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1885.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4158","name":"Ef ped complete intact nut","description":"Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["BA","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95966","name":"Meg evoked single","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61586","name":"Resect nasopharynx skull","description":"Bicoronal, transzygomatic and/or lefort i osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28615","name":"Repair foot dislocation","description":"Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","name":"Anes px art knee&pop nos","description":"Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89125","name":"Specimen fat stain","description":"Fat stain, feces, urine, or respiratory secretions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36831","name":"Open thrombect av fistula","description":"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88386","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90811","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15850","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32422","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34834","name":"Opn brach art expos","description":"Open brachial artery exposure for delivery of endovascular prosthesis, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42400","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33993","name":"Reposg perq r/l hrt vad","description":"Repositioning of percutaneous right or left heart ventricular assist device with imaging guidance at separate and distinct session from insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93642","name":"Ep evl 1/2chmb trnsvns cvdfb","description":"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parame","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29435","name":"Appl patllr tdn bearing cast","description":"Application of patellar tendon bearing (ptb) cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29566.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","name":"Anes th ivnt rad ntrthrc/jug","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11980","name":"Implant hormone pellet(s)","description":"Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10120","name":"Inc&rmvl fb subq tiss smpl","description":"Incision and removal of foreign body, subcutaneous tissues; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91037","name":"Esoph imped function test","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","name":"Anes integ sys rad brst dsj","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77771","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83916","name":"Oligoclonal bands","description":"Oligoclonal immune (oligoclonal bands)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33572","name":"Open coronary endarterectomy","description":"Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or right coronary artery performed in conjunction with coronary artery bypass graft procedure, each vessel (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95927","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74248","name":"X-ray sm int f-thru std","description":"Radiologic small intestine follow-through study, including multiple serial images (list separately in addition to code for primary procedure for upper gi radiologic examination)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69005","name":"Drg xtrnl ear absc/hem comp","description":"Drainage external ear, abscess or hematoma; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33213","name":"Insert pulse gen dual leads","description":"Insertion of pacemaker pulse generator only; with existing dual leads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27712","name":"Osteot mlt relignmt imed rod","description":"Osteotomy; multiple, with realignment on intramedullary rod (eg, sofield type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90743","name":"Hepb vacc 2 dose adolesc im","description":"Hepatitis b vaccine (hepb), adolescent, 2 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48102","name":"Needle biopsy pancreas","description":"Biopsy of pancreas, percutaneous needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69970","name":"Remove inner ear lesion","description":"Removal of tumor, temporal bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1729.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66987","name":"Xcapsl ctrc rmvl cplx w/ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31654","name":"Bronch ebus ivntj perph les","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s) (list separately in addition to code for primary procedure[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01272","name":"Anes px art femoral art lig","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery ligation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21244","name":"Reconstruction of lower jaw","description":"Reconstruction of mandible, extraoral, with transosteal bone plate (eg, mandibular staple bone plate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69662","name":"Revise middle ear bone","description":"Revision of stapedectomy or stapedotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4103","name":"Ef ped fluid and electrolyte","description":"Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64866","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-spinal accessory","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0076T","name":"S&i stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45342","name":"Sigmoidoscopy w/us guide bx","description":"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67345","name":"Destroy nerve of eye muscle","description":"Chemodenervation of extraocular muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42505","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42953","name":"Repair throat esophagus","description":"Pharyngoesophageal repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28810","name":"Amputation toe & metatarsal","description":"Amputation, metatarsal, with toe, single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25126","name":"Remove/graft forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":470.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55873","name":"Cryoablate prostate","description":"Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4988.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30124","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; simple, skin, subcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93526","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24582","name":"Prq skel fix humrl cndylr fx","description":"Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88175","name":"Cytopath c/v auto fluid redo","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25337","name":"Reconstruct ulna/radioulnar","description":"Reconstruction for stabilization of unstable distal ulna or distal radioulnar joint, secondary by soft tissue stabilization (eg, tendon transfer, tendon graft or weave, or tenodesis) with or without open reduction of distal radioulnar joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95803","name":"Actigraphy testing","description":"Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99244","name":"Off/op cnsltj new/est mod 40","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86804","name":"Hep c ab test confirm","description":"Hepatitis c antibody; confirmatory test (eg, immunoblot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"Psytx w pt w e/m 60 min","description":"Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39220","name":"Resect mediastinal tumor","description":"Resection of mediastinal tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63610","name":"Stimulation of spinal cord","description":"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57305","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70373","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54112","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft greater than 5 cm in length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76813","name":"Ob us nuchal meas 1 gest","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77771","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60000","name":"I&d thyroglssl dux cst infct","description":"Incision and drainage of thyroglossal duct cyst, infected","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20245","name":"Bone biopsy open deep","description":"Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00561","name":"Anes px heart w/pump<1 yr","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year of age","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4232","name":"Syringe w/needle insulin 3cc","description":"Syringe with needle for external insulin pump, sterile, 3 cc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0049","name":"Alcohol/drug screening","description":"Alcohol and/or drug screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99235","name":"Hosp ip/obs same date mod 70","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encount","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":288.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28306","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25023","name":"Decompress forearm 1 space","description":"Decompression fasciotomy, forearm and/or wrist, flexor or extensor compartment; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2187.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72114","name":"X-ray exam l-s spine bending","description":"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99325","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92240","name":"Icg angiography i&r uni/bi","description":"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26410","name":"Repair hand tendon","description":"Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30620","name":"Intranasal reconstruction","description":"Septal or other intranasal dermatoplasty (does not include obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95874","name":"Guide nerv destr needle emg","description":"Needle electromyography for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36590","name":"Removal tunneled cv cath","description":"Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99476","name":"Ped crit care age 2-5 subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61885","name":"Insrt/redo neurostim 1 array","description":"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70543","name":"Mri orbt/fac/nck w/o &w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78414","name":"Non-imaging heart function","description":"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67916","name":"Repair eyelid defect","description":"Repair of ectropion; excision tarsal wedge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21550","name":"Biopsy of neck/chest","description":"Biopsy, soft tissue of neck or thorax","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32151","name":"Remove lung foreign body","description":"Thoracotomy; with removal of intrapulmonary foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87337","name":"Entamoeb hist group ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; entamoeba histolytica group","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7076.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70470","name":"Ct head/brain w/o & w/dye","description":"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19361","name":"Brst rcnstj latsms drsi flap","description":"Breast reconstruction; with latissimus dorsi flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57130","name":"Excision vaginal septum","description":"Excision of vaginal septum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35870","name":"Repair vessel graft defect","description":"Repair of graft-enteric fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63303","name":"Remov vert xdrl bdy lmbr/sac","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2748.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45020","name":"Drainage of rectal abscess","description":"Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66986","name":"Exchange lens prosthesis","description":"Exchange of intraocular lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27254","name":"Treat hip dislocation","description":"Open treatment of hip dislocation, traumatic, with acetabular wall and femoral head fracture, with or without internal or external fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1079.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29131","name":"Appl finger splint dynamic","description":"Application of finger splint; dynamic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43121","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52301","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92650","name":"Aep scr auditory potential","description":"Auditory evoked potentials; screening of auditory potential with broadband stimuli, automated analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3670.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":6967.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92549","name":"Cdp-sot 6 cond w/i&r mct&adt","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (mct) and adaptation test (adt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35538","name":"Art byp grft aortobi-iliac","description":"Bypass graft, with vein; aortobi-iliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30125","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; complex, under bone or cartilage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33470","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95922","name":"Autonomic nrv adrenrg inervj","description":"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57180","name":"Treat vaginal bleeding","description":"Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64704","name":"Revise hand/foot nerve","description":"Neuroplasty; nerve of hand or foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86021","name":"Wbc antibody identification","description":"Antibody identification; leukocyte antibodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27265","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52240","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; large bladder tumor(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71555","name":"Mri angio chest w or w/o dye","description":"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39010","name":"Exploration of chest","description":"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; transthoracic approach, including either transthoracic or median sternotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23472","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32036","name":"Thoracostomy w/flap drainage","description":"Thoracostomy; with open flap drainage for empyema","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34151","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; renal, celiac, mesentery, aortoiliac artery, by abdominal incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50548","name":"Laparo remove w/ureter","description":"Laparoscopy, surgical; nephrectomy with total ureterectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1089.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44160","name":"Removal of colon","description":"Colectomy, partial, with removal of terminal ileum with ileocolostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1027.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77316","name":"Brachytx isodose plan simple","description":"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21408","name":"Opn tx orbit fx w/bone grft","description":"Open treatment of fracture of orbit, except blowout; with bone grafting (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47136","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3397.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69605","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99457","name":"Rpm tx mgmt 1st 20 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 20 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5876.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43246","name":"Egd place gastrostomy tube","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11762","name":"Reconstruction of nail bed","description":"Reconstruction of nail bed with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26560","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]},{"negotiated_type":"negotiated","negotiated_rate":2247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99492","name":"1st psyc collab care mgmt","description":"Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0078","name":"Care manag h vst new pt 45 m","description":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38380","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78494","name":"Heart image spect","description":"Cardiac blood pool imaging, gated equilibrium, spect, at rest, wall motion study plus ejection fraction, with or without quantitative processing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43280","name":"Laparoscopy fundoplasty","description":"Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78431","name":"Myocrd img pet rst&strs ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2557.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44955","name":"Appendectomy add-on","description":"Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27647","name":"Resect talus/calcaneus tum","description":"Radical resection of tumor; talus or calcaneus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38205","name":"Harvest allogeneic stem cell","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0481","name":"Intrpulmnry percuss vent sys","description":"Intrapulmonary percussive ventilation system and related accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2508.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1396.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95887","name":"Musc tst done w/n tst nonext","description":"Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1766.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42104","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; without closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93298","name":"Rem interrog dev eval scrms","description":"Interrogation device evaluation(s), (remote) up to 30 days; subcutaneous cardiac rhythm monitor system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6015","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25115","name":"Remove wrist/forearm lesion","description":"Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, tbc, or other granulomas, rheumatoid arthritis); flexors","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27428","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3339.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94774","name":"Ped home apnea mntr evnt rec","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; includes monitor attachment, download of data, review, interpretation, and preparation of a report by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12331.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19287","name":"Perq dev breast 1st mr guide","description":"Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including magnetic resonance guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67405","name":"Explore/drain eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26476","name":"Tendon lengthening","description":"Lengthening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28304","name":"Incision of midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28114","name":"Removal of metatarsal heads","description":"Ostectomy, complete excision; all metatarsal heads, with partial proximal phalangectomy, excluding first metatarsal (eg, clayton type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20702","name":"Mnl prep&insj imed rx dev","description":"Manual preparation and insertion of drug-delivery device(s), intramedullary (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0144","name":"Azithromycin dihydrate, oral","description":"Azithromycin dihydrate, oral, capsules/powder, 1 gram","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35495","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93295","name":"Dev interrog remote 1/2/mlt","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27889","name":"Ankle disarticulation","description":"Ankle disarticulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22319","name":"Treat odontoid fx w/graft","description":"Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with grafting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1663.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87267","name":"Enterovirus antibody dfa","description":"Infectious agent antigen detection by immunofluorescent technique; enterovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36002","name":"Pseudoaneurysm injection trt","description":"Injection procedures (eg, thrombin) for percutaneous treatment of extremity pseudoaneurysm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34820","name":"Opn iliac art expos","description":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31580","name":"Laryngoplasty laryngeal web","description":"Laryngoplasty; for laryngeal web, with indwelling keel or stent insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31205","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; extranasal, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2213","name":"Initiat med assist tx in er","description":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting, including assessment, referral to ongoing care, and arranging access to supportive services (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2332.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15836","name":"Exc excessive skin arm","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3786.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21268","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1702.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52282","name":"Cystoscopy implant stent","description":"Cystourethroscopy, with insertion of permanent urethral stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51992","name":"Laparo sling operation","description":"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28272","name":"Release of toe joint each","description":"Capsulotomy; interphalangeal joint, each joint (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","name":"Anes upr lwr gi ndsc px","description":"Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49611","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); second stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93233","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99377","name":"Hospice care supervision","description":"Supervision of a hospice patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36904","name":"Thrmbc/nfs dialysis circuit","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thromboly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57522","name":"Conization of cervix","description":"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87635","name":"Sars-cov-2 covid-19 amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0248","name":"Hdtrans bench w/wo comm open","description":"Transfer bench, heavy duty, for tub or toilet with or without commode opening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70482","name":"Ct orbit/ear/fossa w/o&w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516T","name":"Insj wcs lv eltrd only","description":"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; electrode only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93350","name":"Stress tte only","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27454","name":"Realignment of thigh bone","description":"Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (eg, sofield type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27427","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; extra-articular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66930","name":"Extraction of lens","description":"Removal of lens material; intracapsular, for dislocated lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47721","name":"Fuse upper gi structures","description":"Cholecystoenterostomy; with gastroenterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62360","name":"Insert spine infusion device","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43774","name":"Lap rmvl gastr adj all parts","description":"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21015","name":"Resect face/scalp tum < 2 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; less than 2 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93460","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93622","name":"Comp ep eval l ventr pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1808.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","name":"Anes px heart w/o pump oxtj","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42420","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":923.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","name":"Anes male gent undscnd tstis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1852.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23334","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":899.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4090.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76813","name":"Ob us nuchal meas 1 gest","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3201","name":"Oxford w supinat/pronat inf","description":"Orthopedic shoe, oxford with supinator or pronator, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88248","name":"Chromosome analysis 50-100","description":"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, fanconi anemia, fragile x)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37214","name":"Cessj therapy cath removal","description":"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55300","name":"Prepare sperm duct x-ray","description":"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75658","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93352","name":"Admin ecg contrast agent","description":"Use of echocardiographic contrast agent during stress echocardiography (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82044","name":"Ur albumin semiquantitative","description":"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65600","name":"Revision of cornea","description":"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"Spirometry up to 2 yrs old","description":"Measurement of spirometric forced expiratory flows in an infant or child through 2 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43425","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; transthoracic or transabdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67227","name":"Dstrj extensive retinopathy","description":"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93325","name":"Doppler echo color flow mapg","description":"Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67903","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3814.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24150","name":"Rad rescj tum dstl/shft hum","description":"Radical resection of tumor, shaft or distal humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1314.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3899.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32486","name":"Sleeve lobectomy","description":"Removal of lung, other than pneumonectomy; with circumferential resection of segment of bronchus followed by broncho-bronchial anastomosis (sleeve lobectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1887.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19300","name":"Mastectomy for gynecomastia","description":"Mastectomy for gynecomastia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1660.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1298.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L4380","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":171.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33545","name":"Repair of heart damage","description":"Repair of postinfarction ventricular septal defect, with or without myocardial resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2677.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10071.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33266","name":"Ablate atria x10sv endo","description":"Endoscopy, surgical; operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure), without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24116","name":"Exc/crtg b1 cst/tum hum algr","description":"Excision or curettage of bone cyst or benign tumor, humerus; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88333","name":"Path consltj surg cyto xm 1","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":28.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28475","name":"Cltx metatarsal fx w/mnpj ea","description":"Closed treatment of metatarsal fracture; with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4203.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99116","name":"Anes comp tot bdy hypthrm","description":"Anesthesia complicated by utilization of total body hypothermia (list separately in addition to code for primary anesthesia procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2096.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63277","name":"Bx/exc xdrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95028","name":"Iq tsts allergy delayed rxn","description":"Intracutaneous (intradermal) tests with allergenic extracts, delayed type reaction, including reading, specify number of tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31717","name":"Bronchial brush biopsy","description":"Catheterization with bronchial brush biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35647","name":"Bpg aortofemoral","description":"Bypass graft, with other than vein; aortofemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93286","name":"Peri-px eval pm/ldls pm ip","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead pacemaker system, or leadless pacemaker ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28010","name":"Incision of toe tendon","description":"Tenotomy, percutaneous, toe; single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51585","name":"Removal of bladder & nodes","description":"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1706.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447T","name":"Rmvl impltbl glucose sensor","description":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93016","name":"Cv stress test supvj only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95147","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 3 single stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","name":"Anes vaginal px nos","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","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, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58559","name":"Hysteroscopy lysis","description":"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86356","name":"Mononuclear cell antigen","description":"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62163","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1354.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49321","name":"Laparoscopy biopsy","description":"Laparoscopy, surgical; with biopsy (single or multiple)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1750.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95721","name":"Eeg phy/qhp>36<60 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 36 hours, up to 60 hours of eeg recording, without video","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36014","name":"Place catheter in artery","description":"Selective catheter placement, left or right pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93890","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"Psytx w pt 60 minutes","description":"Psychotherapy, 60 minutes with patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82541","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24931","name":"Amputate upper arm & implant","description":"Amputation, arm through humerus; with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37237","name":"Open/perq place stent ea add","description":"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36556","name":"Insert non-tunnel cv cath","description":"Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44121","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; each additional resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26210","name":"Removal of finger lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95716","name":"Veeg ea 12-26hr cont mntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67880","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20663","name":"Application halo femoral","description":"Application of halo, including removal; femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99462","name":"Sbsq nb em per day hosp","description":"Subsequent hospital care, per day, for evaluation and management of normal newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73222","name":"Mri joint upr extrem w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78432","name":"Myocrd img pet 2rtracer","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84060","name":"Assay acid phosphatase","description":"Phosphatase, acid; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88388","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23665","name":"Cltx sho dslc fx gr hmrl tbr","description":"Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44407","name":"Colonoscopy w/ndl aspir/bx","description":"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11952","name":"Subq njx fil matrl 5.1-10cc","description":"Subcutaneous injection of filling material (eg, collagen); 5.1 to 10.0 cc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36248","name":"Ins cath abd/l-ext art addl","description":"Selective catheter placement, arterial system; additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (list in addition to code for initial second or third order vessel as appropriate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93975","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33948","name":"Ecmo/ecls daily mgmt-venous","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; daily management, each day, veno-venous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8688","name":"Implt nrostm pls gen dua non","description":"Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54130","name":"Remove penis & nodes","description":"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64633","name":"Destroy cerv/thor facet jnt","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); cervical or thoracic, single facet joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28111","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; first metatarsal head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","name":"Anes open total ankle rplcmt","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24600","name":"Tx clsd elbow dislc w/o anes","description":"Treatment of closed elbow dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27601","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; posterior compartment(s) only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69802","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419T","name":"Dstrj neurofibroma xtnsv","description":"Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); face, head and neck, greater than 50 neurofibromas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86682","name":"Helminth antibody","description":"Antibody; helminth, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","name":"Anes hrna rpr upr abd nos","description":"Anesthesia for hernia repairs in upper abdomen; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78072","name":"Parathyrd planar w/spect&ct","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect), and concurrently acquired computed tomography (ct) for anatomical localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1514.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":709.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37239","name":"Open/perq place stent ea add","description":"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each additional vein (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96522","name":"Refill/maint pump/resvr syst","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27760","name":"Cltx medial ankle fx","description":"Closed treatment of medial malleolus fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86940","name":"Hemolysins/agglutinins auto","description":"Hemolysins and agglutinins; auto, screen, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4678.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9986","name":"Remote e/m est. pt 40mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88120","name":"Cytp urne 3-5 probes ea spec","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","name":"Anes px art knee&pop nos","description":"Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93631","name":"Ntraop epicar&endcar pac&map","description":"Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33860","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2703.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9282","name":"Wig any type","description":"Wig, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47801","name":"Placement bile duct support","description":"Placement of choledochal stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92588","name":"Evoked auditory tst complete","description":"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88275","name":"Cytogenetics 100-300","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75574","name":"Ct angio hrt w/3d image","description":"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34203","name":"Removal of leg artery clot","description":"Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3701","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60522","name":"Removal of thymus gland","description":"Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64492","name":"Inj paravert f jnt c/t 3 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; third and any additional level(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49083","name":"Abd paracentesis w/imaging","description":"Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42600","name":"Closure of salivary fistula","description":"Closure salivary fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23065","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44140","name":"Partial removal of colon","description":"Colectomy, partial; with anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82530","name":"Cortisol free","description":"Cortisol; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27686","name":"Revise lower leg tendons","description":"Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25500","name":"Cltx rdl shft fx w/o mnpj","description":"Closed treatment of radial shaft fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31603","name":"Emer tracheostomy ttrach","description":"Tracheostomy, emergency procedure; transtracheal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88738","name":"Hgb quant transcutaneous","description":"Hemoglobin (hgb), quantitative, transcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64530","name":"N block inj celiac pelus","description":"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4533","name":"Youth size brief/diaper","description":"Youth sized disposable incontinence product, brief/diaper, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37200","name":"Transcatheter biopsy","description":"Transcatheter biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95834","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93293","name":"Pm phone r-strip device eval","description":"Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67010","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57000","name":"Colpotomy w/exploration","description":"Colpotomy; with exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92526","name":"Oral function therapy","description":"Treatment of swallowing dysfunction and/or oral function for feeding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92538","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36222","name":"Place cath carotid/inom art","description":"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0218T","name":"Njx paravert w/us lumb/sac","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; third and any additional level(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33813","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92653","name":"Aep neurodiagnostic i&r","description":"Auditory evoked potentials; neurodiagnostic, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65810","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26477","name":"Tendon shortening","description":"Shortening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83021","name":"Hemoglobin chromotography","description":"Hemoglobin fractionation and quantitation; chromatography (eg, a2, s, c, and/or f)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27654","name":"Repair of achilles tendon","description":"Repair, secondary, achilles tendon, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33050","name":"Resect heart sac lesion","description":"Resection of pericardial cyst or tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87301","name":"Adenovirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; adenovirus enteric types 40/41","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01230","name":"Anes opn upper 2/3 femur nos","description":"Anesthesia for open procedures involving upper two-thirds of femur; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37718","name":"Lig div&strpg short saph vn","description":"Ligation, division, and stripping, short saphenous vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","BA","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69633","name":"Rebuild eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [porp], total ossicular replacement prosthesis [torp])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0190T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47510","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82757","name":"Assay of semen fructose","description":"Fructose, semen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26113","name":"Exc hand tum deep 1.5 cm/>","description":"Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); 1.5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66720","name":"Destruction ciliary body","description":"Ciliary body destruction; cryotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44206","name":"Lap part colectomy w/stoma","description":"Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (hartmann type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1435.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83632","name":"Placental lactogen","description":"Lactogen, human placental (hpl) human chorionic somatomammotropin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75572","name":"Ct hrt w/3d image","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93986","name":"Dup-scan hemo compl uni std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43880","name":"Closure gastrocolic fistula","description":"Closure of gastrocolic fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1326.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1340.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47740","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69910","name":"Remove inner ear & mastoid","description":"Labyrinthectomy; with mastoidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44206","name":"Lap part colectomy w/stoma","description":"Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (hartmann type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1435.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26843","name":"Fusion of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"Spirmtry w/brnchdil inf-2 yr","description":"Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4553.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61605","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1783.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36592","name":"Collect blood from picc","description":"Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61154","name":"Burr hole w/evac&/drg hmtma","description":"Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21010","name":"Incision of jaw joint","description":"Arthrotomy, temporomandibular joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","name":"Anes px hrt w/pump age 1yr+","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90466","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81272","name":"Kit gene targeted seq analys","description":"Kit (v-kit hardy-zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor [gist], acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons 8, 11, 13, 17, 18)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64746","name":"Incise diaphragm nerve","description":"Transection or avulsion of; phrenic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","name":"Anes gastrocnemius recession","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27724","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1067.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49435","name":"Insert subq exten to ip cath","description":"Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72133","name":"Ct lumbar spine w/o & w/dye","description":"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80176","name":"Assay of lidocaine","description":"Lidocaine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96571","name":"Photodynamic tx addl 15 min","description":"Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (list separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0515","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49521","name":"Rerepair ing hernia blocked","description":"Repair recurrent inguinal hernia, any age; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","name":"Anes art sho&ax ax-brch arsm","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80502","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68500","name":"Removal of tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","name":"Anes opn lwr l/a/f rad rescj","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92616","name":"Fees w/laryngeal sense test","description":"Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99238","name":"Hosp ip/obs dschrg mgmt 30/<","description":"Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2794.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3370.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49655","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49021","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71060","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1976.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6202","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4553.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21935","name":"Resect back tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2007","name":"Post-d/c h vst ext pt 30 m","description":"Limited (30 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient faci","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77767","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L9900","name":"O&p supply/accessory/service","description":"Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs l code","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31760","name":"Tracheoplasty intrathoracic","description":"Tracheoplasty; intrathoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68811","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27105","name":"Transfer of spinal muscle","description":"Transfer paraspinal muscle to hip (includes fascial or tendon extension graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61608","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2956.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69200","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; without general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12015","name":"Rpr f/e/e/n/l/m 7.6-12.5 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2213","name":"Initiat med assist tx in er","description":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting, including assessment, referral to ongoing care, and arranging access to supportive services (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P3001","name":"Screening pap smear by phys","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69602","name":"Rev mstdc rslt mod rad mstdc","description":"Revision mastoidectomy; resulting in modified radical mastoidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19350","name":"Nipple/areola reconstruction","description":"Nipple/areola reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63040","name":"Laminotomy single cervical","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43502","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, mallory-weiss)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38724","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (modified radical neck dissection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8778.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36566","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; with subcutaneous port(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3774.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99192","name":"Special pump services","description":"Assembly and operation of pump with oxygenator or heat exchanger (with or without ecg and/or pressure monitoring); 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29821","name":"Sho arthrs srg compl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44050","name":"Reduce bowel obstruction","description":"Reduction of volvulus, intussusception, internal hernia, by laparotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35390","name":"Reoperation carotid add-on","description":"Reoperation, carotid, thromboendarterectomy, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92549","name":"Cdp-sot 6 cond w/i&r mct&adt","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (mct) and adaptation test (adt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15760","name":"Composite skin graft","description":"Graft; composite (eg, full thickness of external ear or nasal ala), including primary closure, donor area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21248","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99316","name":"Nf dschrg mgmt 30 min+","description":"Nursing facility discharge management; more than 30 minutes total time on the date of the encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40831","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; over 2.5 cm or complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33622","name":"Redo compl cardiac anomaly","description":"Reconstruction of complex cardiac anomaly (eg, single ventricle or hypoplastic left heart) with palliation of single ventricle with aortic outflow obstruction and aortic arch hypoplasia, creation of cavopulmonary anastomosis, and removal of right and left pulmonary bands (eg, hybrid approach stage 2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3001.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78831","name":"Rp loclzj tum spect 2 areas","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0072A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42225","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; attachment pharyngeal flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1976.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27616","name":"Resect leg/ankle tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of leg or ankle area; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1087.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43320","name":"Fuse esophagus & stomach","description":"Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal or transthoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4526","name":"Adult size pull-on med","description":"Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21432","name":"Optx cranfcl sep w/wiring","description":"Open treatment of craniofacial separation (lefort iii type); with wiring and/or internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97546","name":"Work hardening add-on","description":"Work hardening/conditioning; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70488","name":"Ct maxillofacial w/o & w/dye","description":"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2034.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45389","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2456.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5376.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35556","name":"Art byp grft fem-popliteal","description":"Bypass graft, with vein; femoral-popliteal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1233.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1373.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93308","name":"Tte f-up or lmtd","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20938","name":"Sp bone agrft struct add-on","description":"Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial incision) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4045.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","name":"Anes px heart w/pmp crc arst","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3619.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15850","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88334","name":"Path consltj surg cyto xm ea","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49610","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); first stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21451","name":"Cltx mndblr fx w/mnpj","description":"Closed treatment of mandibular fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11311","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63172","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33412","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with transventricular aortic annulus enlargement (konno procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2749.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93453","name":"R&l hrt cath w/ventriclgrphy","description":"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50783","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with extensive ureteral tailoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90746","name":"Hepb vaccine 3 dose adult im","description":"Hepatitis b vaccine (hepb), adult dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83065","name":"Hemoglobin thermolabile","description":"Hemoglobin; thermolabile","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","name":"Anes px heart w/pmp crc arst","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87502","name":"Influenza dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, first 2 types or sub-types","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8750.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6763.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27202","name":"Treat tail bone fracture","description":"Open treatment of coccygeal fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61791","name":"Treat trigeminal tract","description":"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46916","name":"Cryosurgery anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86022","name":"Platelet antibodies","description":"Antibody identification; platelet antibodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20838","name":"Replantation foot complete","description":"Replantation, foot, complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2367.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31240","name":"Nsl/sns ndsc cnch bull rescj","description":"Nasal/sinus endoscopy, surgical; with concha bullosa resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","name":"Neuraxl lbr anes vag dlvr","description":"Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88289","name":"Chromosome study additional","description":"Chromosome analysis; additional high resolution study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69222","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1390.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73523","name":"X-ray exam hips bi 5/> views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21453","name":"Cltx mndblr fx ntrdntl fixj","description":"Closed treatment of mandibular fracture with interdental fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1139.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36583","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1027.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58573","name":"Tlh w/t/o uterus over 250 g","description":"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67335","name":"Eye suture during surgery","description":"Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (list separately in addition to code for specific strabismus surgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":942.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96922","name":"Excimer lsr psriasis>500sqcm","description":"Excimer laser treatment for psoriasis; over 500 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33426","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2070.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36870","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93571","name":"Iv dop vel&/press c flo 1st","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; initial vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85549","name":"Muramidase","description":"Muramidase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99221","name":"1st hosp ip/obs sf/low 40","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. when using total time on the date of the encounter for code selection, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26686","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; complex, multiple, or delayed reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62230","name":"Replace/revise brain shunt","description":"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32445","name":"Removal of lung extrapleural","description":"Removal of lung, pneumonectomy; extrapleural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2839.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49322","name":"Laparoscopy aspiration","description":"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86001","name":"Allergen specific igg","description":"Allergen specific igg quantitative or semiquantitative, each allergen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9615","name":"Urine specimen collect mult","description":"Catheterization for collection of specimen(s) (multiple patients)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5067.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84704","name":"Hcg free betachain test","description":"Gonadotropin, chorionic (hcg); free beta chain","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36902","name":"Intro cath dialysis circuit","description":"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous out","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27448","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; without fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46230","name":"Removal of anal tags","description":"Excision of multiple external papillae or tags, anus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3223.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1306.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10737.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22858","name":"Tot disc arthrp 2nd lvl crv","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84252","name":"Assay of vitamin b-2","description":"Riboflavin (vitamin b-2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43288","name":"Esphg thrsc moblj","description":"Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, th","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3136.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26765","name":"Treat finger fracture each","description":"Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation, when performed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83525","name":"Assay of insulin","description":"Insulin; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86920","name":"Compatibility test spin","description":"Compatibility test each unit; immediate spin technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92511","name":"Nasopharyngoscopy","description":"Nasopharyngoscopy with endoscope (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95887","name":"Musc tst done w/n tst nonext","description":"Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0092","name":"Set up port xray equipment","description":"Set-up portable x-ray equipment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26130","name":"Remove wrist joint lining","description":"Synovectomy, carpometacarpal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33670","name":"Repair of heart chambers","description":"Repair of complete atrioventricular canal, with or without prosthetic valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1719.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77417","name":"Ther radiology port image(s)","description":"Therapeutic radiology port image(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93640","name":"Ep eval 1/2chmbr pacg cvdfb","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21079","name":"Impres&prep intrm obt prosth","description":"Impression and custom preparation; interim obturator prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":976.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31512","name":"Removal of larynx lesion","description":"Laryngoscopy, indirect; with removal of lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69110","name":"Remove external ear partial","description":"Excision external ear; partial, simple repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11107","name":"Incal bx skn ea sep/addl","description":"Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); each separate/additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4841.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50387","name":"Change nephroureteral cath","description":"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57460","name":"Bx of cervix w/scope leep","description":"Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0075T","name":"Perq stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32654","name":"Thoracoscopy contrl bleeding","description":"Thoracoscopy, surgical; with control of traumatic hemorrhage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":914.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31515","name":"Laryngoscopy for aspiration","description":"Laryngoscopy direct, with or without tracheoscopy; for aspiration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3960.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0460","name":"Autolog prp not diab ulcer","description":"Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedures, administration and dressings, per treatment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","name":"Anes hernia repair<1 yr age","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, younger than 1 year of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11102","name":"Tangntl bx skin single les","description":"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77049","name":"Mri breast c-+ w/cad bi","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90465","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26591","name":"Repair muscles of hand","description":"Repair, intrinsic muscles of hand, each muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74178","name":"Ct abd&plv wo cntr flwd cntr","description":"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80418","name":"Pituitary evaluation panel","description":"Combined rapid anterior pituitary evaluation panel this panel must include the following: adrenocorticotropic hormone (acth) (82024 x 4) luteinizing hormone (lh) (83002 x 4) follicle stimulating hormone (fsh) (83001 x 4) prolactin (84146 x 4) human growth hormone (hgh) (83003 x 4) cortisol (82533 x ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22856","name":"Tot disc arthrp 1ntrspc crv","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83500","name":"Assay free hydroxyproline","description":"Hydroxyproline; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93018","name":"Cv stress test i&r only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3292.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20615","name":"Treatment of bone cyst","description":"Aspiration and injection for treatment of bone cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50785","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with vesico-psoas hitch or bladder flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27645","name":"Resect tibia tumor","description":"Radical resection of tumor; tibia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98972","name":"Nqhp ol dig assmt&mgmt 21+","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24360","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with membrane (eg, fascial)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76125","name":"Cine/video x-rays add-on","description":"Cineradiography/videoradiography to complement routine examination (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36590","name":"Removal tunneled cv cath","description":"Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67039","name":"Laser treatment of retina","description":"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8936.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54164","name":"Frenulotomy of penis","description":"Frenulotomy of penis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61613","name":"Remove aneurysm sinus","description":"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3017.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78452","name":"Ht muscle image spect mult","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or red","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99307","name":"Sbsq nf care sf mdm 10","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0456","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76814","name":"Ob us nuchal meas add-on","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88302","name":"Tissue exam by pathologist","description":"Level ii - surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incident","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87533","name":"Hhv-6 dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78481","name":"Heart first pass single","description":"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88140","name":"Sex chromatin identification","description":"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97161","name":"Pt eval low complex 20 min","description":"Physical therapy evaluation: low complexity, requiring these components: a history with no personal factors and/or comorbidities that impact the plan of care; an examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96365","name":"Ther/proph/diag iv inf init","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85170","name":"Blood clot retraction","description":"Clot retraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95012","name":"Nitric oxide exp gas deter","description":"Nitric oxide expired gas determination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40819","name":"Excise lip or cheek fold","description":"Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57426","name":"Revise prosth vag graft lap","description":"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68040","name":"Treatment of eyelid lesions","description":"Expression of conjunctival follicles (eg, for trachoma)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75945","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65270","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9869","name":"Cmmi asyntelehealth 10-20min","description":"Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, 10-20 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93283","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantab","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15240","name":"Fth/gft f/c/c/m/n/ax/g/h/f20","description":"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17107","name":"Dstr cut vsc prlf les10-50sq","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); 10.0 to 50.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96920","name":"Excimer lsr psriasis<250sqcm","description":"Excimer laser treatment for psoriasis; total area less than 250 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26145","name":"Tendon excision palm/finger","description":"Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86592","name":"Syphilis test non-trep qual","description":"Syphilis test, non-treponemal antibody; qualitative (eg, vdrl, rpr, art)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88162","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6416.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27158","name":"Revision of pelvis","description":"Osteotomy, pelvis, bilateral (eg, congenital malformation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46947","name":"Hemorrhoidopexy by stapling","description":"Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19380","name":"Revj reconstructed breast","description":"Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83695","name":"Assay of lipoprotein(a)","description":"Lipoprotein (a)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1481.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1309.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90956","name":"Esrd srv 1 visit p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional per month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25101","name":"Explore/treat wrist joint","description":"Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96411","name":"Chemo iv push addl drug","description":"Chemotherapy administration; intravenous, push technique, each additional substance/drug (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29035","name":"Appl body cast sho to hips","description":"Application of body cast, shoulder to hips;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99226","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26205","name":"Remove/graft bone lesion","description":"Excision or curettage of bone cyst or benign tumor of metacarpal; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78072","name":"Parathyrd planar w/spect&ct","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect), and concurrently acquired computed tomography (ct) for anatomical localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2556.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77768","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78803","name":"Rp loclzj tum spect 1 area","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93308","name":"Tte f-up or lmtd","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2285.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86353","name":"Lymphocyte transformation","description":"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95992","name":"Canalith repositioning proc","description":"Canalith repositioning procedure(s) (eg, epley maneuver, semont maneuver), per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95874","name":"Guide nerv destr needle emg","description":"Needle electromyography for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86603","name":"Adenovirus antibody","description":"Antibody; adenovirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96573","name":"Pdt dstr prmlg les phys/qhp","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43310","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":51.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82300","name":"Assay of cadmium","description":"Cadmium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86706","name":"Hep b surface antibody","description":"Hepatitis b surface antibody (hbsab)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1751.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11982","name":"Remove drug implant device","description":"Removal, non-biodegradable drug delivery implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":206.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51920","name":"Close bladder-uterus fistula","description":"Closure of vesicouterine fistula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92311","name":"Contact lens fitg aphakia 1","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, 1 eye","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93291","name":"Interrog dev eval scrms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; subcutaneous cardiac rhythm monitor system, including heart rhythm derived data analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","name":"Anes arthr/ndsc tot wrst rpl","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36561","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5394.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27228","name":"Treat hip fracture(s)","description":"Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes t-fracture and both column fracture with complete articular detachment, or single column or transverse fracture with associated acetabular wall fracture, with internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1594.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","name":"Anes opn/arthrs px elbw nos","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64568","name":"Opn impltj crnl nrv nea&pg","description":"Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20936","name":"Sp bone agrft local add-on","description":"Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":39.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5349.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77300","name":"Radiation therapy dose plan","description":"Basic radiation dosimetry calculation, central axis depth dose calculation, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","name":"Anes cardiac catheterization","description":"Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include swan-ganz catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28011","name":"Incision of toe tendons","description":"Tenotomy, percutaneous, toe; multiple tendons","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42280","name":"Preparation palate mold","description":"Maxillary impression for palatal prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88313","name":"Special stains group 2","description":"Special stain including interpretation and report; group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21355","name":"Perq tx malar fracture","description":"Percutaneous treatment of fracture of malar area, including zygomatic arch and malar tripod, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80502","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44381","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; with transendoscopic balloon dilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47552","name":"Biliary endo perq dx w/speci","description":"Biliary endoscopy, percutaneous via t-tube or other tract; diagnostic, with collection of specimen(s) by brushing and/or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70488","name":"Ct maxillofacial w/o & w/dye","description":"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83015","name":"Heavy metal qual any number","description":"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53010","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4178","name":"Parenteral sol amino acid >","description":"Parenteral nutrition solution: amino acid, greater than 8.5% (500 ml = 1 unit) - home mix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0128","name":"Corf skilled nursing service","description":"Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87522","name":"Hepatitis c revrs trnscrpj","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, quantification, includes reverse transcription when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37785","name":"Ligate/divide/excise vein","description":"Ligation, division, and/or excision of varicose vein cluster(s), 1 leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38745","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86891","name":"Autologous blood op salvage","description":"Autologous blood or component, collection processing and storage; intra- or postoperative salvage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24940","name":"Revision of upper arm","description":"Cineplasty, upper extremity, complete procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94350","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61533","name":"Implant brain electrodes","description":"Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1394.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67840","name":"Remove eyelid lesion","description":"Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43282","name":"Lap paraesoph her rpr w/mesh","description":"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64681","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30020","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal septum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3241.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93624","name":"Ep f-up study pacg&rec","description":"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1504.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","name":"Anes open px lower l/a/f nos","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2292","name":"Planar seat for ped size wc","description":"Seat, planar, for pediatric size wheelchair including fixed attaching hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33978","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64874","name":"Repair & revise nerve add-on","description":"Suture of nerve; requiring extensive mobilization, or transposition of nerve (list separately in addition to code for nerve suture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69155","name":"Extensive ear/neck surgery","description":"Radical excision external auditory canal lesion; with neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1325.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1825","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45160","name":"Excision of rectal lesion","description":"Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76950","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63103","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic or lumbar, each additional segment (list separately in addition to code for primary proc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15837","name":"Exc excsv skin forearm/hand","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37186","name":"Sec art thrombectomy add-on","description":"Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections, provided in conjunction with a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76880","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0311","name":"Immunize counsel 16-30 mins","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 16-30 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55821","name":"Removal of prostate","description":"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90817","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"Office o/p est low 20 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or e","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["95","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59610","name":"Vbac delivery","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1974.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25335","name":"Centralization wrist on ulna","description":"Centralization of wrist on ulna (eg, radial club hand)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58770","name":"Create new tubal opening","description":"Salpingostomy (salpingoneostomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92242","name":"Fluorescein&icg angiography","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96417","name":"Chemo iv infus each addl seq","description":"Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69610","name":"Tympanic membrane repair","description":"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49411","name":"Ins mark abd/pel for rt perq","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61580","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2058.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62329","name":"Ther spi pnxr csf fluor/ct","description":"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or ct guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87526","name":"Hepatitis g dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24605","name":"Tx clsd elbow dislc req anes","description":"Treatment of closed elbow dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94781","name":"Cars/bd tst inft-12mo +30min","description":"Car seat/bed testing for airway integrity, for infants through 12 months of age, with continual clinical staff observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; each additional full 30 minutes (list separately in addition to code","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99172","name":"Ocular function screen","description":"Visual function screening, automated or semi-automated bilateral quantitative determination of visual acuity, ocular alignment, color vision by pseudoisochromatic plates, and field of vision (may include all or some screening of the determination[s] for contrast sensitivity, vision under glare)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92605","name":"Ex for nonspeech device rx","description":"Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33776","name":"Rpr tga atr bfl clsr vsd","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with closure of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1701.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86353","name":"Lymphocyte transformation","description":"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98968","name":"Ph1 assmt&mgmt nqhp 21-30","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27409","name":"Repair of knee ligaments","description":"Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36005","name":"Injection ext venography","description":"Injection procedure for extremity venography (including introduction of needle or intracatheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","name":"Anes upr gi ndsc px nos","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28232","name":"Incision of toe tendon","description":"Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54840","name":"Remove epididymis lesion","description":"Excision of spermatocele, with or without epididymectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01758","name":"Anes opn/arthrs elbw exc cst","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; excision of cyst or tumor of humerus","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50080","name":"Perq nl/pl lithotrp smpl<2cm","description":"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; simple (eg, stone[s] up to 2 cm in single location of kidney or renal pelvis, nonbranching ston","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","name":"Anes hrna rpr upr abd nos","description":"Anesthesia for hernia repairs in upper abdomen; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61541","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for transection of corpus callosum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1970.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3215","name":"Orthopedic ftwear ladies oxf","description":"Orthopedic footwear, ladies shoe, oxford, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0077","name":"Care manag h vst new pt 30 m","description":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63744","name":"Revision of spinal shunt","description":"Replacement, irrigation or revision of lumbosubarachnoid shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99497","name":"Advncd care plan 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surroga","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27070","name":"Part remove hip bone super","description":"Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46612","name":"Anoscopy remove lesions","description":"Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33510","name":"Cabg vein single","description":"Coronary artery bypass, vein only; single coronary venous graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1681.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26060","name":"Incision of finger tendon","description":"Tenotomy, percutaneous, single, each digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29888","name":"Arthrs aid acl rpr/agmntj","description":"Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36224","name":"Place cath carotd art","description":"Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1697.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"Home/res vst new sf mdm 15","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6506.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32160","name":"Open chest heart massage","description":"Thoracotomy; with cardiac massage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":387.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2063","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11743.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99474","name":"Self-meas bp 2 readg bid 30d","description":"Self-measured blood pressure using a device validated for clinical accuracy; separate self-measurements of two readings one minute apart, twice daily over a 30-day period (minimum of 12 readings), collection of data reported by the patient and/or caregiver to the physician or other qualified health ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36469","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":961.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84133","name":"Assay of urine potassium","description":"Potassium; urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82540","name":"Assay of creatine","description":"Creatine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26445","name":"Release hand/finger tendon","description":"Tenolysis, extensor tendon, hand or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59614","name":"Vbac care after delivery","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1017.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75573","name":"Ct hrt c+ strux cgen hrt ds","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3d image postprocessing, assessment of left ventricular [lv] cardiac function, right ventricular [rv] structure and function and evaluation of ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","name":"Anes px vn lwr leg ven thrmb","description":"Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52005","name":"Cysto w/urtrl cathj","description":"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54328","name":"Revise penis/urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88325","name":"Consltj compre rvw rec reprt","description":"Consultation, comprehensive, with review of records and specimens, with report on referred material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32140","name":"Removal of lung lesion(s)","description":"Thoracotomy; with cyst(s) removal, includes pleural procedure when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33275","name":"Tcat rmvl perm ldls pm w/img","description":"Transcatheter removal of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45317","name":"Proctosigmoidoscopy bleed","description":"Proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27386","name":"Repair/graft of thigh muscle","description":"Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87320","name":"Chlmyd trach ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; chlamydia trachomatis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63091","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93227","name":"Xtrnl ecg rec<48 hr r&i","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44901","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96377","name":"Applicaton on-body injector","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4040.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15931","name":"Exc sacral pr ulc prim sutr","description":"Excision, sacral pressure ulcer, with primary suture;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25645","name":"Optx crpl fx oth/thn scph ea","description":"Open treatment of carpal bone fracture (other than carpal scaphoid [navicular]), each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95954","name":"Eeg monitoring/giving drugs","description":"Pharmacological or physical activation requiring physician or other qualified health care professional attendance during eeg recording of activation phase (eg, thiopental activation test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95722","name":"Eeg phy/qhp>36<60 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 36 hours, up to 60 hours of eeg recording, with video (veeg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26437","name":"Realignment of tendons","description":"Realignment of extensor tendon, hand, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37239","name":"Open/perq place stent ea add","description":"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each additional vein (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93356","name":"Myocrd strain img spckl trck","description":"Myocardial strain imaging using speckle tracking-derived assessment of myocardial mechanics (list separately in addition to codes for echocardiography imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29280","name":"Strapping of hand or finger","description":"Strapping; hand or finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31800","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3265.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26530","name":"Revise knuckle joint","description":"Arthroplasty, metacarpophalangeal joint; each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14747.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45130","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; perineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92130","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3546.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57020","name":"Colpocentesis sep px","description":"Colpocentesis (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35879","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch angioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28200","name":"Repair of foot tendon","description":"Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80436","name":"Metyrapone panel","description":"Metyrapone panel this panel must include the following: cortisol (82533 x 2) 11 deoxycortisol (82634 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42440","name":"Excise submaxillary gland","description":"Excision of submandibular (submaxillary) gland","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23440","name":"Remove/transplant tendon","description":"Resection or transplantation of long tendon of biceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61558","name":"Excision of skull/sutures","description":"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82382","name":"Assay urine catecholamines","description":"Catecholamines; total urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28450","name":"Tx tarsal b1 fx w/o mnpj ea","description":"Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96422","name":"Chemo ia infusion up to 1 hr","description":"Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28260","name":"Release of midfoot joint","description":"Capsulotomy, midfoot; medial release only (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95145","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); single stinging insect venom","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4083","name":"Enteral stomach tube levine","description":"Stomach tube - levine type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61026","name":"Injection into brain canal","description":"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93005","name":"Electrocardiogram tracing","description":"Electrocardiogram, routine ecg with at least 12 leads; tracing only, without interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73725","name":"Mr ang lwr ext w or w/o dye","description":"Magnetic resonance angiography, lower extremity, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23570","name":"Cltx scapular fx w/o mnpj","description":"Closed treatment of scapular fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43313","name":"Esophagoplasty congenital","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2265.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26392","name":"Repair/graft hand tendon","description":"Removal of synthetic rod and insertion of flexor tendon graft, hand or finger (includes obtaining graft), each rod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92518","name":"Vemp test i&r ocular","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; ocular (ovemp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8170.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90801","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95831","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]},{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KL","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64784","name":"Remove nerve lesion","description":"Excision of neuroma; major peripheral nerve, except sciatic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83906","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37192","name":"Redo endovas vena cava filtr","description":"Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35663","name":"Bpg ilioiliac","description":"Bypass graft, with other than vein; ilioiliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3095.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85385","name":"Fibrinogen antigen","description":"Fibrinogen; antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23530","name":"Optx strnclav dislc aqt/chrn","description":"Open treatment of sternoclavicular dislocation, acute or chronic;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33414","name":"Repair of aortic valve","description":"Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1870.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2749.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14350","name":"Filleted finger/toe flap","description":"Filleted finger or toe flap, including preparation of recipient site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15776","name":"Hair trnspl >15 punch grafts","description":"Punch graft for hair transplant; more than 15 punch grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80418","name":"Pituitary evaluation panel","description":"Combined rapid anterior pituitary evaluation panel this panel must include the following: adrenocorticotropic hormone (acth) (82024 x 4) luteinizing hormone (lh) (83002 x 4) follicle stimulating hormone (fsh) (83001 x 4) prolactin (84146 x 4) human growth hormone (hgh) (83003 x 4) cortisol (82533 x ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99143","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1586.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11426","name":"Exc h-f-nk-sp b9+marg >4 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62162","name":"Remove colloid cyst w/scope","description":"Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1727.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33464","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; with ring insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2119.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15321","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0506","name":"Comp asses care plan ccm svc","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","name":"Anes all px nrv musc upr leg","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A4397","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2087","name":"Off base opioid tx, 60 m","description":"Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54318","name":"Reconstruction of urethra","description":"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage cecil repair)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86386","name":"Nuclear matrix protein 22","description":"Nuclear matrix protein 22 (nmp22), qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24120","name":"Exc/crtg b1 cst/b9 tum rds","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76983","name":"Use ea addl target lesion","description":"Ultrasound, elastography; each additional target lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61490","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1556.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2595.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11980","name":"Implant hormone pellet(s)","description":"Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48150","name":"Partial removal of pancreas","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); with pancreatojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2609.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90953","name":"Esrd serv 1 visit p mo <2yrs","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92018","name":"Compl oph exam general anes","description":"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40816","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1717","name":"Brachytx, non-str,hdr ir-192","description":"Brachytherapy source, non-stranded, high dose rate iridium-192, per source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B5200","name":"Parenteral sol hepatic fream","description":"Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, stress-branch chain amino acids-freamine-hbc-premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67961","name":"Revision of eyelid","description":"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; up to one-fourth of lid margin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4088","name":"Gastro/jejuno tube, low-pro","description":"Gastrostomy/jejunostomy tube, low-profile, any material, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2355.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0394","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31367","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, without radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1642.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76881","name":"Us compl joint r-t w/img","description":"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6024","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44346","name":"Revision of colostomy","description":"Revision of colostomy; with repair of paracolostomy hernia (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0445","name":"Oximeter non-invasive","description":"Oximeter device for measuring blood oxygen levels non-invasively","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24362","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with implant and fascia lata ligament reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93281","name":"Pm device progr eval multi","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27216","name":"Treat pelvic ring fracture","description":"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral (includes ipsilateral ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51565","name":"Revise bladder & ureter(s)","description":"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20561","name":"Ndl insj w/o njx 3+ musc","description":"Needle insertion(s) without injection(s); 3 or more muscles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1314.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93592","name":"Perq transcath closure each","description":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64463","name":"Pvb thoracic cont infusion","description":"Paravertebral block (pvb) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52325","name":"Cystoscopy stone removal","description":"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87520","name":"Hepatitis c rna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2643.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KC","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57109","name":"Vagnc bi total pel lymphadec","description":"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66179","name":"Aqueous shunt eye w/o graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60650","name":"Laparoscopy adrenalectomy","description":"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55400","name":"Repair of sperm duct","description":"Vasovasostomy, vasovasorrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17315","name":"Mohs surg addl block","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), e","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28470","name":"Cltx metatarsal fx wo mnp ea","description":"Closed treatment of metatarsal fracture; without manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21931","name":"Exc back les sc 3 cm/>","description":"Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82938","name":"Gastrin test","description":"Gastrin after secretin stimulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0511","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47136","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3397.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49656","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52310","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61330","name":"Dcmprn orbit only transcrnl","description":"Decompression of orbit only, transcranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1638.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01484","name":"Anes opn lw l/a/f oste/ostpl","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94619","name":"Exercise tst brncspsm wo ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; without electrocardiographic recording(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47701","name":"Bile duct revision","description":"Portoenterostomy (eg, kasai procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1457.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1853.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11056","name":"Parng/cutg b9 hyprkr les 2-4","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33880","name":"Evasc rpr ta ndgft cov lsa","description":"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment of an aorto-aortic tube endograft covering the left subclavian artery and all aortic tube endograft e","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1568.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38300","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68325","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93325","name":"Doppler echo color flow mapg","description":"Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74247","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33840","name":"Exc coa w/direct anastomosis","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with direct anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76814","name":"Ob us nuchal meas add-on","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0459","name":"Telehealth inpt pharm mgmt","description":"Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35721","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78832","name":"Rp loclzj tum spect w/ct 2","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":582.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97762","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30915","name":"Ligation nasal sinus artery","description":"Ligation arteries; ethmoidal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27057","name":"Buttock fasciotomy w/dbrdmt","description":"Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle) with debridement of nonviable muscle, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82747","name":"Assay of folic acid rbc","description":"Folic acid; rbc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82746","name":"Assay of folic acid serum","description":"Folic acid; serum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0500","name":"Mod sedat endo service >5yrs","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousness ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25118","name":"Excise wrist tendon sheath","description":"Synovectomy, extensor tendon sheath, wrist, single compartment;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36905","name":"Thrmbc/nfs dialysis circuit","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thromboly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31730","name":"Intro windpipe wire/tube","description":"Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","name":"Anes px art lower leg emblc","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85675","name":"Thrombin time titer","description":"Thrombin time; titer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57335","name":"Repair vagina","description":"Vaginoplasty for intersex state","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","name":"Anes iper upr abd pncrtect","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, whipple procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87800","name":"Detect agnt mult dna direc","description":"Infectious agent detection by nucleic acid (dna or rna), multiple organisms; direct probe(s) technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"Medical nutrition group","description":"Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83050","name":"Hgb methemoglobin quan","description":"Hemoglobin; methemoglobin, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99483","name":"Assmt & care pln pt cog imp","description":"Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements: cognition-focused evaluation including a pertinent history and examination, m","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86774","name":"Tetanus antibody","description":"Antibody; tetanus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50953","name":"Endoscopy of ureter","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32601","name":"Thoracoscopy diagnostic","description":"Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, mediastinal or pleural space, without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26520","name":"Release knuckle contracture","description":"Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43605","name":"Biopsy of stomach","description":"Biopsy of stomach, by laparotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0071A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33945","name":"Transplantation of heart","description":"Heart transplant, with or without recipient cardiectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90937","name":"Hemodialysis repeated eval","description":"Hemodialysis procedure requiring repeated evaluation(s) with or without substantial revision of dialysis prescription","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78223","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96102","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31288","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61571","name":"Incise skull for brain wound","description":"Craniectomy or craniotomy; with treatment of penetrating wound of brain","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65750","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in aphakia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54500","name":"Biopsy of testis","description":"Biopsy of testis, needle (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49412","name":"Ins device for rt guide open","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if performed, single or multiple (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88741","name":"Transcutaneous methb","description":"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74221","name":"X-ray xm esophagus 2cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84080","name":"Assay alkaline phosphatases","description":"Phosphatase, alkaline; isoenzymes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26565","name":"Correct metacarpal flaw","description":"Osteotomy; metacarpal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86805","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; with titration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B5000","name":"Parenteral sol renal-amirosy","description":"Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, renal-aminosyn-rf, nephramine, renamine-premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45380","name":"Colonoscopy and biopsy","description":"Colonoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27420","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; (eg, hauser type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58145","name":"Myomectomy vag method","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35506","name":"Art byp grft subclav-carotid","description":"Bypass graft, with vein; carotid-subclavian or subclavian-carotid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1125.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95808","name":"Polysom any age 1-3> param","description":"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51841","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); complicated (eg, secondary repair)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4110.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93572","name":"Iv dop vel&/press c flo ea","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4657.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20663","name":"Application halo femoral","description":"Application of halo, including removal; femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69604","name":"Revj mstdc rsltg tympanplsty","description":"Revision mastoidectomy; resulting in tympanoplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3798.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6506.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22511","name":"Perq lumbosacral injection","description":"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1458.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25136","name":"Remove & graft wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","name":"Anes opn/arthr elb tot rplct","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34848","name":"Visc & infraren abd 4+ prost","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2396.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37790","name":"Penile venous occlusion","description":"Penile venous occlusive procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1768","name":"Graft, vascular","description":"Graft, vascular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33412","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with transventricular aortic annulus enlargement (konno procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2749.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","name":"Anes opn/arthr tot sho rplcm","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29530","name":"Strapping of knee","description":"Strapping; knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0455","name":"Fecal microbiota prep instil","description":"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33243","name":"Remove eltrd/thoracotomy","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1185.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34834","name":"Opn brach art expos","description":"Open brachial artery exposure for delivery of endovascular prosthesis, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523T","name":"Ntrapx c ffr w/3d funcjl map","description":"Intraprocedural coronary fractional flow reserve (ffr) with 3d functional mapping of color-coded ffr values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention (list separately in addition to code ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61798","name":"Srs cranial lesion complex","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26352","name":"Repair/graft hand tendon","description":"Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no mans land); secondary with free graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16036","name":"Escharotomy ea addl incision","description":"Escharotomy; each additional incision (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95966","name":"Meg evoked single","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2054.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60240","name":"Removal of thyroid","description":"Thyroidectomy, total or complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63710","name":"Graft repair of spine defect","description":"Dural graft, spinal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21454","name":"Optx mndblr fx xtrnl fixj","description":"Open treatment of mandibular fracture with external fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44155","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, with proctectomy; with ileostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1682.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64446","name":"Njx aa&/strd sc nrv nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20970","name":"Bone/skin graft iliac crest","description":"Free osteocutaneous flap with microvascular anastomosis; iliac crest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2428.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6007","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47712","name":"Excision of bile duct tumor","description":"Excision of bile duct tumor, with or without primary repair of bile duct; intrahepatic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80305","name":"Drug test prsmv dir opt obs","description":"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","name":"Anes cls px upr tib fib&/pat","description":"Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42450","name":"Excise sublingual gland","description":"Excision of sublingual gland","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77785","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99494","name":"1st/sbsq psyc collab care","description":"Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82952","name":"Gtt-added samples","description":"Glucose; tolerance test, each additional beyond 3 specimens (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27086","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; subcutaneous tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82106","name":"Alpha-fetoprotein amniotic","description":"Alpha-fetoprotein (afp); amniotic fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99238","name":"Hosp ip/obs dschrg mgmt 30/<","description":"Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8105.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]},{"negotiated_type":"negotiated","negotiated_rate":4270.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92507","name":"Tx sp lang voice comm indiv","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64876","name":"Repair nerve/shorten bone","description":"Suture of nerve; requiring shortening of bone of extremity (list separately in addition to code for nerve suture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21183","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 40 sq cm but less than 80 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1950.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","name":"Anes thoracotomy px nos","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61332","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1790.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29846","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62367","name":"Analyze spine infus pump","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming or refill","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6213","name":"Foam drg >16<=48 sq in w/bdr","description":"Foam 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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["AW","GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78587","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36148","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31715","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1126.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26517","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 2 digits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78451","name":"Ht muscle image spect sing","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33984","name":"Ecmo/ecls rmvl prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, 6 years and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23575","name":"Cltx scap fx w/mnpj +-tractj","description":"Closed treatment of scapular fracture; with manipulation, with or without skeletal traction (with or without shoulder joint involvement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67318","name":"Revise eye muscle(s)","description":"Strabismus surgery, any procedure, superior oblique muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43420","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2634.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8460","name":"Camisole post-mast","description":"Camisole, post-mastectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20934","name":"Intercalary algrft compl","description":"Allograft, includes templating, cutting, placement and internal fixation, when performed; intercalary, complete (ie, cylindrical) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45397","name":"Lap remove rectum w/pouch","description":"Laparoscopy, surgical; proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, j-pouch), with diverting enterostomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1699.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61641","name":"Dilat ic vspsm ea vsl sm ter","description":"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50970","name":"Ureter endoscopy","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44392","name":"Colonoscopy & polypectomy","description":"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93545","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44620","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3010.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81439","name":"Hrdtry cardmypy gene panel","description":"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at least 5 cardiomyopathy-related genes (eg, dsg2, mybpc3, myh7, pkp2, ttn)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35650","name":"Bpg axillary-axillary","description":"Bypass graft, with other than vein; axillary-axillary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33285","name":"Insj subq car rhythm mntr","description":"Insertion, subcutaneous cardiac rhythm monitor, including programming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4074.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26615","name":"Treat metacarpal fracture","description":"Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68745","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22327","name":"Treat thorax spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1341.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66020","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); air or liquid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95925","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29830","name":"Elbow arthroscopy","description":"Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24665","name":"Optx radial head/neck fx","description":"Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38300","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"Office o/p new hi 60 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86619","name":"Borrelia antibody","description":"Antibody; borrelia (relapsing fever)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64454","name":"Njx aa&/strd gnclr nrv brnch","description":"Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33702","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1341.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85612","name":"Viper venom prothrombin time","description":"Russell viper venom time (includes venom); undiluted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43285","name":"Rmvl esophgl sphnctr dev","description":"Removal of esophageal sphincter augmentation device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15773","name":"Grfg autol fat lipo 25 cc/<","description":"Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29806","name":"Sho arthrs srg capsulorraphy","description":"Arthroscopy, shoulder, surgical; capsulorrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35600","name":"Open hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45337","name":"Sigmoidoscopy & decompress","description":"Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23490","name":"Reinforce clavicle","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; clavicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0324","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83951","name":"Oncoprotein dcp","description":"Oncoprotein; des-gamma-carboxy-prothrombin (dcp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81518","name":"Onc brst mrna 11 genes","description":"Oncology (breast), mrna, gene expression profiling by real-time rt-pcr of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage risk for metastatic recurrence and likelihood of benefit from extended endocrine therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1936.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0412","name":"Open tx iliac spine uni/bil","description":"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3909.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56630","name":"Vulvectomy radical partial","description":"Vulvectomy, radical, partial;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93565","name":"Njx car cth slctv lv/la ang","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0250","name":"Md inr test revie inter mgmt","description":"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of servic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33947","name":"Ecmo/ecls initiation artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-arterial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33504","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83701","name":"Lipoprotein bld hr fraction","description":"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35702","name":"Expl n/flwd surg uxtr art","description":"Exploration not followed by surgical repair, artery; upper extremity (eg, axillary, brachial, radial, ulnar)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62120","name":"Repair skull cavity lesion","description":"Repair of encephalocele, skull vault, including cranioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16025","name":"Dress/debrid p-thick burn m","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93622","name":"Comp ep eval l ventr pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11667.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]},{"negotiated_type":"negotiated","negotiated_rate":4728.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63030","name":"Lamot dcmprn nrv rt 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":859.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58543","name":"Lsh uterus above 250 g","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33310","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); without bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1413.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36500","name":"Insertion of catheter vein","description":"Venous catheterization for selective organ blood sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29086","name":"Application cast finger","description":"Application, cast; finger (eg, contracture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89321","name":"Semen anal sperm detection","description":"Semen analysis; sperm presence and motility of sperm, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19001","name":"Puncture aspir cyst brst ea","description":"Puncture aspiration of cyst of breast; each additional cyst (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77058","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64823","name":"Sympathectomy supfc palmar","description":"Sympathectomy; superficial palmar arch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47562","name":"Laparoscopic cholecystectomy","description":"Laparoscopy, surgical; cholecystectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90826","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93226","name":"Xtrnl ecg rec<48 hr scan a/r","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38206","name":"Harvest auto stem cells","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["AW","GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","name":"Anes integ sys rad/modf brst","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0340","name":"Robt lin-radsurg fractx 2-5","description":"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2012.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4670","name":"Automatic bp monitor, dial","description":"Automatic blood pressure monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23210","name":"Radical rescj tumor scapula","description":"Radical resection of tumor; scapula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21356","name":"Opn tx dprsd zygomatic arch","description":"Open treatment of depressed zygomatic arch fracture (eg, gillies approach)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99366","name":"Team conf w/pat by hc prof","description":"Medical team conference with interdisciplinary team of health care professionals, face-to-face with patient and/or family, 30 minutes or more, participation by nonphysician qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47143","name":"Prep donor liver whole","description":"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; without triseg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31512","name":"Removal of larynx lesion","description":"Laryngoscopy, indirect; with removal of lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87278","name":"Legion pneumophilia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; legionella pneumophila","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30100","name":"Intranasal biopsy","description":"Biopsy, intranasal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29750","name":"Wedging of clubfoot cast","description":"Wedging of clubfoot cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27340","name":"Removal of kneecap bursa","description":"Excision, prepatellar bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3786.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15950","name":"Exc trchntr pr ulc prim sutr","description":"Excision, trochanteric pressure ulcer, with primary suture;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53425","name":"Reconstruct urethra stage 2","description":"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33965","name":"Ecmo/ecls rmvl perph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64809","name":"Sympathectomy thoracolumbar","description":"Sympathectomy, thoracolumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11442","name":"Exc face-mm b9+marg 1.1-2 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99496","name":"Transj care mgmt high f2f 7d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge high level of medical decision making during the service period face-to-face visit, within 7 calenda","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35251","name":"Rpr blvsl vn grf intra-abdl","description":"Repair blood vessel with vein graft; intra-abdominal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1526.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15420","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50706","name":"Balloon dilate urtrl strix","description":"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99465","name":"Nb resuscitation","description":"Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35537","name":"Art byp grft aortoiliac","description":"Bypass graft, with vein; aortoiliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64857","name":"Repair arm/leg nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84203","name":"Test rbc protoporphyrin","description":"Protoporphyrin, rbc; screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27457","name":"Realignment of knee","description":"Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); after epiphyseal closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85347","name":"Coagulation time activated","description":"Coagulation time; activated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","name":"Anes art sho&ax ax-fem bpg","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90876","name":"Psychophysiological therapy","description":"Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 45 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2096.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93609","name":"Intra-vntr mapg tchycar site","description":"Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27269","name":"Optx thigh fx","description":"Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26990","name":"Drainage of pelvis lesion","description":"Incision and drainage, pelvis or hip joint area; deep abscess or hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2466.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86171","name":"Complement fixation each","description":"Complement fixation tests, each antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27000","name":"Tenotomy adductor hip perq","description":"Tenotomy, adductor of hip, percutaneous (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77409","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21557","name":"Resect neck thorax tumor<5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46750","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; adult","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4525","name":"Adult size pull-on sm","description":"Adult sized disposable incontinence product, protective underwear/pull-on, small size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33926","name":"Repr pul art unifocal w/cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2106.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP04","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93542","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31288","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30920","name":"Ligation upper jaw artery","description":"Ligation arteries; internal maxillary artery, transantral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61539","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2168.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83840","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AV","AU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32491","name":"Lung volume reduction","description":"Removal of lung, other than pneumonectomy; with resection-plication of emphysematous lung(s) (bullous or non-bullous) for lung volume reduction, sternal split or transthoracic approach, includes any pleural procedure, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1174.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32605","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29126","name":"Appl short arm splint dyn","description":"Application of short arm splint (forearm to hand); dynamic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22533.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84238","name":"Assay nonendocrine receptor","description":"Receptor assay; non-endocrine (specify receptor)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28306","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81189","name":"Cstb gene full gene sequence","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; full gene sequence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36456","name":"Prtl exchange transfuse nb","description":"Partial exchange transfusion, blood, plasma or crystalloid necessitating the skill of a physician or other qualified health care professional, newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27235","name":"Treat thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, proximal end, neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37186","name":"Sec art thrombectomy add-on","description":"Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections, provided in conjunction with a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95713","name":"Veeg 2-12 hr cont mntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, 2-12 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52270","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; female","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93320","name":"Doppler echo complete","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95874","name":"Guide nerv destr needle emg","description":"Needle electromyography for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2004","name":"Post-d/c h vst new pt 60 m","description":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient faci","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82415","name":"Assay of chloramphenicol","description":"Chloramphenicol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83071","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54304","name":"Revision of penis","description":"Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35883","name":"Revj fem anast nonautog grf","description":"Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86325","name":"Other immunoelectrophoresis","description":"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00561","name":"Anes px heart w/pump<1 yr","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year of age","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0081","name":"Care man h v ext pt 20 mi","description":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37185","name":"Prim art m-thrmbc sbsq vsl","description":"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); second and all subsequent vessel(s) within the same vascular family (list separa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71040","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67820","name":"Revise eyelashes","description":"Correction of trichiasis; epilation, by forceps only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1686.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50592","name":"Perc rf ablate renal tumor","description":"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2586.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","name":"Tumor immunohistochem/manual","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0408","name":"Inpt/tele follow up 35","description":"Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82355","name":"Calculus analysis qual","description":"Calculus; qualitative analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93524","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44391","name":"Colonoscopy for bleeding","description":"Colonoscopy through stoma; with control of bleeding, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65155","name":"Reinsert ocular implant","description":"Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91110","name":"Gi trc img intral esoph-ile","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15770","name":"Derma-fat-fascia graft","description":"Graft; derma-fat-fascia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56805","name":"Clitoroplasty intersex state","description":"Clitoroplasty for intersex state","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37718","name":"Lig div&strpg short saph vn","description":"Ligation, division, and stripping, short saphenous vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51727","name":"Cystometrogram w/up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84376","name":"Sugars single qual","description":"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37218","name":"Stent placemt ante carotid","description":"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84510","name":"Assay of tyrosine","description":"Tyrosine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81539","name":"Oncology prostate prob score","description":"Oncology (high-grade prostate cancer), biochemical assay of four proteins (total psa, free psa, intact psa, and human kallikrein-2 [hk2]), utilizing plasma or serum, prognostic algorithm reported as a probability score","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28295","name":"Cor hlx vlgs prx mtar osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal metatarsal osteotomy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29505","name":"Application long leg splint","description":"Application of long leg splint (thigh to ankle or toes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35612","name":"Bpg subclavian-subclavian","description":"Bypass graft, with other than vein; subclavian-subclavian","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64418","name":"Njx aa&/strd sprscap nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82952","name":"Gtt-added samples","description":"Glucose; tolerance test, each additional beyond 3 specimens (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43881","name":"Impl/rplcmt gstr nstim eltrd","description":"Implantation or replacement of gastric neurostimulator electrodes, antrum, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29888","name":"Arthrs aid acl rpr/agmntj","description":"Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6543","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46744","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2967.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42507","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59514","name":"Cesarean delivery only","description":"Cesarean delivery only;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22514","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59151","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95954","name":"Eeg monitoring/giving drugs","description":"Pharmacological or physical activation requiring physician or other qualified health care professional attendance during eeg recording of activation phase (eg, thiopental activation test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51596","name":"Remove bladder/create pouch","description":"Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1905.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51500","name":"Removal of bladder cyst","description":"Excision of urachal cyst or sinus, with or without umbilical hernia repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99050","name":"Medical services after hrs","description":"Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed (eg, holidays, saturday or sunday), in addition to basic service","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0130","name":"Single energy x-ray study","description":"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5008","name":"Hearing screening","description":"Hearing screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22522","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65450","name":"Treatment of corneal lesion","description":"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26740","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; without manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57500","name":"Biopsy of cervix","description":"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95806","name":"Sleep study unatt&resp efft","description":"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0239","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21240","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87073","name":"Culture bacteria anaerobic","description":"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26556","name":"Toe joint transfer","description":"Transfer, free toe joint, with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2879.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29866","name":"Autgrft implnt knee w/scope","description":"Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty) (includes harvesting of the autograft[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15276","name":"Skin sub graft f/n/hf/g addl","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62325","name":"Njx interlaminar crv/thrc","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thorac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96416","name":"Chemo prolong infuse w/pump","description":"Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82024","name":"Assay of acth","description":"Adrenocorticotropic hormone (acth)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95971","name":"Alys smpl sp/pn npgt w/prgrm","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82436","name":"Assay of urine chloride","description":"Chloride; urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11971","name":"Rmvl tis xpndr wo insj implt","description":"Removal of tissue expander without insertion of implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77770","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80164","name":"Assay dipropylacetic acd tot","description":"Valproic acid (dipropylacetic acid); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93568","name":"Njx car cth nslc p-art angrp","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50953","name":"Endoscopy of ureter","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25316","name":"Revise palsy hand tendon(s)","description":"Flexor origin slide (eg, for cerebral palsy, volkmann contracture), forearm and/or wrist; with tendon(s) transfer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49906","name":"Free omental flap microvasc","description":"Free omental flap with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61535","name":"Remove brain electrodes","description":"Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27758","name":"Treatment of tibia fracture","description":"Open treatment of tibial shaft fracture (with or without fibular fracture), with plate/screws, with or without cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7133.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99379","name":"Nursing fac care supervision","description":"Supervision of a nursing facility patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, comm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71270","name":"Ct thorax dx c-/c+","description":"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88249","name":"Chromosome analysis 100","description":"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin c, ionizing radiation, uv radiation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5010","name":"Assessment for hearing aid","description":"Assessment for hearing aid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90880","name":"Hypnotherapy","description":"Hypnotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93306","name":"Tte w/doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1021.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66184","name":"Revision of aqueous shunt","description":"Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38765","name":"Remove groin lymph nodes","description":"Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82528","name":"Assay of corticosterone","description":"Corticosterone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66680","name":"Repair iris & ciliary body","description":"Repair of iris, ciliary body (as for iridodialysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86668","name":"Francisella tularensis","description":"Antibody; francisella tularensis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15050","name":"Pinch graft up to 2 cm diam","description":"Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2826.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38212","name":"Rbc depletion of harvest","description":"Transplant preparation of hematopoietic progenitor cells; red blood cell removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35741","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90887","name":"Interpj/explnaj rslt psyc xm","description":"Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data to family or other responsible persons, or advising them how to assist patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69535","name":"Remove part of temporal bone","description":"Resection temporal bone, external approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2141.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0121","name":"Colon ca scrn not hi rsk ind","description":"Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41512","name":"Tongue suspension","description":"Tongue base suspension, permanent suture technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36831","name":"Open thrombect av fistula","description":"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2448.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49041","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0315","name":"Counsel immune <21 5-15 m","description":"Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10022","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43198","name":"Esophagosc flex trnsn biopsy","description":"Esophagoscopy, flexible, transnasal; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23930","name":"I&d upr a/e dp absc/hmtma","description":"Incision and drainage, upper arm or elbow area; deep abscess or hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33770","name":"Rpr tga w/o surg enlgmnt vsd","description":"Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; without surgical enlargement of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87149","name":"Dna/rna direct probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, direct probe technique, per culture or isolate, each organism probed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4026.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35702","name":"Expl n/flwd surg uxtr art","description":"Exploration not followed by surgical repair, artery; upper extremity (eg, axillary, brachial, radial, ulnar)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83935","name":"Assay of urine osmolality","description":"Osmolality; urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A7011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11302","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96366","name":"Ther/proph/diag iv inf addon","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30801","name":"Ablate inf turbinate superf","description":"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64763","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30915","name":"Ligation nasal sinus artery","description":"Ligation arteries; ethmoidal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13121","name":"Cmplx rpr s/a/l 2.6-7.5 cm","description":"Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33970","name":"Aortic circulation assist","description":"Insertion of intra-aortic balloon assist device through the femoral artery, open approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33505","name":"Repair artery w/tunnel","description":"Repair of anomalous coronary artery from pulmonary artery origin; with construction of intrapulmonary artery tunnel (takeuchi procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1799.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77003","name":"Fluoroguide for spine inject","description":"Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61020","name":"Remove brain cavity fluid","description":"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49606","name":"Repair umbilical lesion","description":"Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":952.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42845","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1731.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521T","name":"Interrog dev eval wcs ip","description":"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78227","name":"Hepatobil syst image w/drug","description":"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2587.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","name":"Anes thoracotomy px nos","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77048","name":"Mri breast c-+ w/cad uni","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6200","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24320","name":"Tenoplasty elbow to sho 1","description":"Tenoplasty, with muscle transfer, with or without free graft, elbow to shoulder, single (seddon-brookes type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51772","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4855.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24670","name":"Cltx ulnar fx prox w/o mnpj","description":"Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49440","name":"Place gastrostomy tube perc","description":"Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33367","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95922","name":"Autonomic nrv adrenrg inervj","description":"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96154","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","name":"Anes opn px upr tib fib&/pat","description":"Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","name":"Anes ivntl rad icr icar/aort","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or aortic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93619","name":"Comprehensive ep evaluation","description":"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21073","name":"Mnpj of tmj w/anesth","description":"Manipulation of temporomandibular joint(s) (tmj), therapeutic, requiring an anesthesia service (ie, general or monitored anesthesia care)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4707","name":"Bicarbonate conc pow per pac","description":"Bicarbonate concentrate, powder, for hemodialysis, per packet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4660","name":"Sphyg/bp app w cuff and stet","description":"Sphygmomanometer/blood pressure apparatus with cuff and stethoscope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66985","name":"Insert lens prosthesis","description":"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88230","name":"Tissue culture lymphocyte","description":"Tissue culture for non-neoplastic disorders; lymphocyte","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27380","name":"Repair of kneecap tendon","description":"Suture of infrapatellar tendon; primary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42409","name":"Drainage of salivary cyst","description":"Marsupialization of sublingual salivary cyst (ranula)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27558","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair, with augmentation/reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43328","name":"Esoph fundoplasty thor","description":"Esophagogastric fundoplasty partial or complete; thoracotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27695","name":"Repair of ankle ligament","description":"Repair, primary, disrupted ligament, ankle; collateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27041","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88273","name":"Cytogenetics 10-30","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33259","name":"Ablate atria w/bypass add-on","description":"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2000.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66820","name":"Incision secondary cataract","description":"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (ziegler or wheeler knife)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28981.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51595","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57700","name":"Revision of cervix","description":"Cerclage of uterine cervix, nonobstetrical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62141","name":"Crnop skull defect>5 cm diam","description":"Cranioplasty for skull defect; larger than 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93321","name":"Doppler echo f-up/lmtd std","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24100","name":"Arthrt elbw synovial bx only","description":"Arthrotomy, elbow; with synovial biopsy only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26449","name":"Release forearm/hand tendon","description":"Tenolysis, complex, extensor tendon, finger, including forearm, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420T","name":"Dstrj neurofibroma xtnsv","description":"Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); trunk and extremities, extensive, greater than 100 neurofibromas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81422","name":"Fetal chrmoml microdeltj","description":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, digeorge syndrome, cri-du-chat syndrome), circulating cell-free fetal dna in maternal blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"Acoustic refl threshold tst","description":"Acoustic reflex testing, threshold","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","name":"Anes opn px upr tib fib&/pat","description":"Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26499","name":"Correction claw finger other","description":"Correction claw finger, other methods","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31611","name":"Constj trachesophgl fstl","description":"Construction of tracheoesophageal fistula and subsequent insertion of an alaryngeal speech prosthesis (eg, voice button, blom-singer prosthesis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75561","name":"Cardiac mri for morph w/dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12052","name":"Intmd rpr face/mm 2.6-5.0 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87530","name":"Hsv dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31715","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49440","name":"Place gastrostomy tube perc","description":"Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2008","name":"Post-d/c h vst ext pt 45 m","description":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient fac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27036","name":"Capsulectomy/capsulotomy hip","description":"Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone, with release of hip flexor muscles (ie, gluteus medius, gluteus minimus, tensor fascia latae, rectus femoris, sartorius, iliopsoas)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22207","name":"Incis spine 3 column lumbar","description":"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2107.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28290","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61686","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4382.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94360","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77771","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50780","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of single ureter to bladder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33501","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75961","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93227","name":"Xtrnl ecg rec<48 hr r&i","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11010","name":"Debride skin at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin and subcutaneous tissues","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49406","name":"Image cath fluid peri/retro","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43255","name":"Egd control bleeding any","description":"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29880","name":"Arthrs kne srg mnisectmy m&l","description":"Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15630","name":"Delay flap eye/nos/ear/lip","description":"Delay of flap or sectioning of flap (division and inset); at eyelids, nose, ears, or lips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57282","name":"Colpopexy extraperitoneal","description":"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88273","name":"Cytogenetics 10-30","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6473.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34710","name":"Dlyd plmt xtn prosth 1st vsl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27301","name":"Drain thigh/knee lesion","description":"Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61583","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2595.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0603","name":"Electric breast pump","description":"Breast pump, electric (ac and/or dc), any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15738","name":"Muscle-skin graft leg","description":"Muscle, myocutaneous, or fasciocutaneous flap; lower extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78708","name":"K flow/funct image w/drug","description":"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83010","name":"Assay of haptoglobin quant","description":"Haptoglobin; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37235","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2048.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41800","name":"Drainage of gum lesion","description":"Drainage of abscess, cyst, hematoma from dentoalveolar structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96113","name":"Devel tst phys/qhp ea addl","description":"Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24145","name":"Prtl exc bone radial h/n","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), radial head or neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95873","name":"Guide nerv destr elec stim","description":"Electrical stimulation for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63046","name":"Lam facetec & foramot thrc","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28225","name":"Release of foot tendon","description":"Tenolysis, extensor, foot; single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27826","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of fibula only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2903.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6246.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42425","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43234","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20704","name":"Mnl prep&insj i-artic rx dev","description":"Manual preparation and insertion of drug-delivery device(s), intra-articular (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25335","name":"Centralization wrist on ulna","description":"Centralization of wrist on ulna (eg, radial club hand)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63282","name":"Bx/exc idrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1802.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31087","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":820.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96127","name":"Brief emotional/behav assmt","description":"Brief emotional/behavioral assessment (eg, depression inventory, attention-deficit/hyperactivity disorder [adhd] scale), with scoring and documentation, per standardized instrument","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23655","name":"Cltx sho dslc w/mnpj w/anes","description":"Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28008","name":"Incision of foot fascia","description":"Fasciotomy, foot and/or toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"Review patient spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; review and interpretation only by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35587","name":"Vein byp pop-tibl peroneal","description":"In-situ vein bypass; popliteal-tibial, peroneal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5480.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24301","name":"Musc/tdn transfer upr a/e 1","description":"Muscle or tendon transfer, any type, upper arm or elbow, single (excluding 24320-24331)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25443","name":"Arthrp prostc dstl scph crpl","description":"Arthroplasty with prosthetic replacement; scaphoid carpal (navicular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3464.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00792","name":"Anes iper upr abd prtl hptc","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; partial hepatectomy or management of liver hemorrhage (excluding liver biopsy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35510","name":"Art byp grft carotid-brchial","description":"Bypass graft, with vein; carotid-brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25450","name":"Epiphysl arrst dstl rds/ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius or ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":54.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3438.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78591","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82486","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76125","name":"Cine/video x-rays add-on","description":"Cineradiography/videoradiography to complement routine examination (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26432","name":"Repair finger tendon","description":"Closed treatment of distal extensor tendon insertion, with or without percutaneous pinning (eg, mallet finger)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22590","name":"Arthrd pst tq craniocervical","description":"Arthrodesis, posterior technique, craniocervical (occiput-c2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0306","name":"Cbc/diffwbc w/o platelet","description":"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95966","name":"Meg evoked single","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66740","name":"Destruction ciliary body","description":"Ciliary body destruction; cyclodialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11006","name":"Dbrdmt skin xtrnl gent per","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia, perineum and abdominal wall, with or without fascial closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61440","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1646.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99406","name":"Behav chng smoking 3-10 min","description":"Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84630","name":"Assay of zinc","description":"Zinc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50551","name":"Kidney endoscopy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58958","name":"Resc recr ovr tbl pp utr mal","description":"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy and limited para-aortic lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65125","name":"Revise ocular implant","description":"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93282","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C1879","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27503","name":"Treatment of thigh fracture","description":"Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, with manipulation, with or without skin or skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01130","name":"Anes body cast appl/revj","description":"Anesthesia for body cast application or revision","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67808","name":"Remove eyelid lesion(s)","description":"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8911","name":"Mra w/o fol w/cont, chest","description":"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64901","name":"Nerve graft add-on","description":"Nerve graft, each additional nerve; single strand (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15953","name":"Exc trchntr pr ulc flp ostc","description":"Excision, trochanteric pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23550","name":"Optx acromclv dislc aqt/chrn","description":"Open treatment of acromioclavicular dislocation, acute or chronic;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88329","name":"Path consltj drg surg","description":"Pathology consultation during surgery;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99177","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with on-site analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21422","name":"Optx palatal/max fracture","description":"Open treatment of palatal or maxillary fracture (lefort i type);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86829","name":"Hla class i/ii antibody qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to hla class i or class ii hla antigens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35476","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1143.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32652","name":"Thoracoscopy rem totl cortex","description":"Thoracoscopy, surgical; with total pulmonary decortication, including intrapleural pneumonolysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1328.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4045.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63078","name":"Spine disk surgery thorax","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25545","name":"Optx ulnar shft fx int fixj","description":"Open treatment of ulnar shaft fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":18.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92974","name":"Cath place cardio brachytx","description":"Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2053.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36625","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); cutdown","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33523","name":"Cabg art-vein six or more","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51727","name":"Cystometrogram w/up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21345","name":"Closed tx nose/jaw fx","description":"Closed treatment of nasomaxillary complex fracture (lefort ii type), with interdental wire fixation or fixation of denture or splint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4929","name":"Tourniquet for dialysis, ea","description":"Tourniquet for dialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28010","name":"Incision of toe tendon","description":"Tenotomy, percutaneous, toe; single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0241U","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","name":"Anes art f/arm wrst&hnd nos","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60270","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32673","name":"Thoracoscopy w/thymus resect","description":"Thoracoscopy, surgical; with resection of thymus, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":972.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3047.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1235.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","name":"Anes integ sys rad/modf brst","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9507.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35450","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59140","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; cervical, with evacuation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01931","name":"Anes ivnt rad ntrhpt/prt crc","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrahepatic or portal circulation (eg, transvenous intrahepatic portosystemic shunt[s] [tips])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54560","name":"Exploration for testis","description":"Exploration for undescended testis with abdominal exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28230","name":"Incision of foot tendon(s)","description":"Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85576","name":"Blood platelet aggregation","description":"Platelet, aggregation (in vitro), each agent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2160.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["BA","UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84235","name":"Assay of endocrine hormone","description":"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24310","name":"Tnot opn elbw to sho ea tdn","description":"Tenotomy, open, elbow to shoulder, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1605.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0245T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20206","name":"Biopsy muscle perq needle","description":"Biopsy, muscle, percutaneous needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28605","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12041","name":"Intmd rpr n-hf/genit 2.5cm/<","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3132.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95939","name":"C motor evoked upr&lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63282","name":"Bx/exc idrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1802.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33786","name":"Repair arterial trunk","description":"Total repair, truncus arteriosus (rastelli type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1984.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32110","name":"Explore/repair chest","description":"Thoracotomy; with control of traumatic hemorrhage and/or repair of lung tear","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80182","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99156","name":"Mod sed oth phys/qhp 5/>yrs","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient age 5 year","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44361","name":"Small bowel endoscopy/biopsy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36818","name":"Av fuse uppr arm cephalic","description":"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43350","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","name":"Anes arthr/ndsc wrst/hnd nos","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83528","name":"Assay of intrinsic factor","description":"Intrinsic factor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84202","name":"Assay rbc protoporphyrin","description":"Protoporphyrin, rbc; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63746","name":"Removal of spinal shunt","description":"Removal of entire lumbosubarachnoid shunt system without replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4708.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":8936.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23921","name":"Disarticulation sho sec clsr","description":"Disarticulation of shoulder; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61760","name":"Implant brain electrodes","description":"Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1442.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93291","name":"Interrog dev eval scrms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; subcutaneous cardiac rhythm monitor system, including heart rhythm derived data analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","name":"Anes ther ivntl rad ven nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1619.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90587","name":"Dengue vacc quad 3 dose subq","description":"Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95705","name":"Eeg w/o vid 2-12 hr unmntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, 2-12 hours; unmonitored","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77520","name":"Proton trmt simple w/o comp","description":"Proton treatment delivery; simple, without compensation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8339.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2084.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95722","name":"Eeg phy/qhp>36<60 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 36 hours, up to 60 hours of eeg recording, with video (veeg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94667","name":"Mnpj chest wall 1st","description":"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23605","name":"Cltx prx hmrl fx mnpj+-tract","description":"Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation, with or without skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33800","name":"Aortic suspension","description":"Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0219T","name":"Plmt post facet implt cerv","description":"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31641","name":"Bronchoscopy treat blockage","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (eg, laser therapy, cryotherapy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95249","name":"Cont gluc mntr pt prov eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook-up, calibration of monitor, patient training, and printout of recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97168","name":"Ot re-eval est plan care","description":"Re-evaluation of occupational therapy established plan of care, requiring these components: an assessment of changes in patient functional or medical status with revised plan of care; an update to the initial occupational profile to reflect changes in condition or environment that affect future inte","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63055","name":"Decompress spinal cord thrc","description":"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1467.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2212","name":"Prolong outpt/office vis","description":"Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or w","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27339","name":"Exc thigh/knee tum dep 5cm/>","description":"Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8839.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90845","name":"Psychoanalysis","description":"Psychoanalysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69424","name":"Remove ventilating tube","description":"Ventilating tube removal requiring general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28052","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; metatarsophalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43124","name":"Removal of esophagus","description":"Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3173.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94725","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23172","name":"Sequestrectomy scapula","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), scapula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21045","name":"Extensive jaw surgery","description":"Excision of malignant tumor of mandible; radical resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31601","name":"Planned tracheostomy<2 yrs","description":"Tracheostomy, planned (separate procedure); younger than 2 years","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96146","name":"Psycl/nrpsyc tst auto result","description":"Psychological or neuropsychological test administration, with single automated, standardized instrument via electronic platform, with automated result only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2584.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4732.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77404","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B5000","name":"Parenteral sol renal-amirosy","description":"Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, renal-aminosyn-rf, nephramine, renamine-premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96136","name":"Psycl/nrpsyc tst phy/qhp 1st","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74712","name":"Mri fetal sngl/1st gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21603","name":"Exc ch wal tum w/lymphadec","description":"Excision of chest wall tumor involving rib(s), with plastic reconstruction; with mediastinal lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1509.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24155","name":"Resection of elbow joint","description":"Resection of elbow joint (arthrectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14001","name":"Tis trnfr trunk 10.1-30sqcm","description":"Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57100","name":"Biopsy vaginal mucosa simple","description":"Biopsy of vaginal mucosa; simple (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96132","name":"Nrpsyc tst eval phys/qhp 1st","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the pati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29883","name":"Arthrs kne srg mnisc rpr m&l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial and lateral)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38211","name":"Tumor cell deplete of harvst","description":"Transplant preparation of hematopoietic progenitor cells; tumor cell depletion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73723","name":"Mri joint lwr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15788","name":"Chemical peel facial epidrm","description":"Chemical peel, facial; epidermal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46614","name":"Anoscopy control bleeding","description":"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","name":"Anes ivntl rad icr icar/aort","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or aortic","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94761","name":"N-invas ear/pls oximetry mlt","description":"Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","name":"Anes nrv msc upr a&e tndsis","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84126","name":"Assay of feces porphyrins","description":"Porphyrins, feces, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71552","name":"Mri chest w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29895","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66710","name":"Ciliary transsleral therapy","description":"Ciliary body destruction; cyclophotocoagulation, transscleral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95962","name":"Electrode stim brain add-on","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0412","name":"Open tx iliac spine uni/bil","description":"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86340","name":"Intrinsic factor antibody","description":"Intrinsic factor antibodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86800","name":"Thyroglobulin antibody","description":"Thyroglobulin antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66183","name":"Insert ant drainage device","description":"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84484","name":"Assay of troponin quant","description":"Troponin, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38531","name":"Open bx/exc inguinofem nodes","description":"Biopsy or excision of lymph node(s); open, inguinofemoral node(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26390","name":"Revise hand/finger tendon","description":"Excision flexor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3909","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87169","name":"Macroscopic exam parasite","description":"Macroscopic examination; parasite","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74245","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"Home/res vst new mod mdm 60","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","name":"Anes hrna rpr lmbr&vnt&/dehs","description":"Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2749.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33779","name":"Rpr tga rcnstj rmvl plm bnd","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with removal of pulmonary band","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93295","name":"Dev interrog remote 1/2/mlt","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22222","name":"Osteot dsc ant 1vrt sgm thrc","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1581.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7239.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27438","name":"Revise kneecap with implant","description":"Arthroplasty, patella; with prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45338","name":"Sigmoidoscopy w/tumr remove","description":"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81320","name":"Plcg2 gene common variants","description":"Plcg2 (phospholipase c gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, r665w, s707f, l845f)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35371","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; common femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64837","name":"Repair nerve add-on","description":"Suture of each additional nerve, hand or foot (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0516","name":"Insert drug del implant, >=4","description":"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77001","name":"Fluoroguide for vein device","description":"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic su","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","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, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22844","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22208","name":"Incis spine 3 column adl seg","description":"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88302","name":"Tissue exam by pathologist","description":"Level ii - surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incident","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62281","name":"Treat spinal cord lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83861","name":"Microfluid analy tears","description":"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21800","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9482","name":"Remote e/m new pt 20mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decisi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88141","name":"Cytopath c/v interpret","description":"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33788","name":"Revision of pulmonary artery","description":"Reimplantation of an anomalous pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1332.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95130","name":"Immntx 1 sting insect","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; single stinging insect venom","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1760","name":"Closure dev, vasc","description":"Closure device, vascular (implantable/insertable)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24075","name":"Exc arm/elbow les sc < 3 cm","description":"Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26474","name":"Fusion of finger tendons","description":"Tenodesis; of distal joint, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96409","name":"Chemo iv push sngl drug","description":"Chemotherapy administration; intravenous, push technique, single or initial substance/drug","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33726","name":"Repair pul venous stenosis","description":"Repair of pulmonary venous stenosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1768.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1467.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95991","name":"Spin/brain pump refil & main","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requiring skill of a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81166","name":"Brca1 gene full dup/del alys","description":"Brca1 (brca1, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86406","name":"Particle agglut antbdy titr","description":"Particle agglutination; titer, each antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22595","name":"Arthrd pst tq atlas-axis","description":"Arthrodesis, posterior technique, atlas-axis (c1-c2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1349.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33891","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24346","name":"Reconstruct elbow med ligmnt","description":"Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55845","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1104.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","name":"Anes px nrv msc upr a&e tnot","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12011","name":"Rpr f/e/e/n/l/m 2.5 cm/<","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75685","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74230","name":"X-ray xm swlng funcj c+","description":"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35271","name":"Rpr blvs gr ot/th vn ntrth w","description":"Repair blood vessel with graft other than vein; intrathoracic, with bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37204","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10737.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2994.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"Esrd home pt serv p mo <2yrs","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93986","name":"Dup-scan hemo compl uni std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31830","name":"Revise windpipe scar","description":"Revision of tracheostomy scar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58561","name":"Hysteroscopy remove myoma","description":"Hysteroscopy, surgical; with removal of leiomyomata","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68200","name":"Treat eyelid by injection","description":"Subconjunctival injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330T","name":"Tear film img uni/bi w/i&r","description":"Tear film imaging, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63620","name":"Srs spinal lesion","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78429","name":"Myocrd img pet 1 std w/ct","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83520","name":"Immunoassay quant nos nonab","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43250","name":"Egd cautery tumor polyp","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0222T","name":"Plmt post facet implt addl","description":"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38510","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep cervical node(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","KM","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35600","name":"Open hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4232.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84302","name":"Assay of sweat sodium","description":"Sodium; other source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4529","name":"Ped size brief/diaper sm/med","description":"Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84061","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99421","name":"Ol dig e/m svc 5-10 min","description":"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27470","name":"Repair of thigh","description":"Repair, nonunion or malunion, femur, distal to head and neck; without graft (eg, compression technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31643","name":"Diag bronchoscope/catheter","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of catheter(s) for intracavitary radioelement application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98968","name":"Ph1 assmt&mgmt nqhp 21-30","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20816","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes metacarpophalangeal joint to insertion of flexor sublimis tendon), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21550","name":"Biopsy of neck/chest","description":"Biopsy, soft tissue of neck or thorax","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29085","name":"Appl cast hand&lwr forearm","description":"Application, cast; hand and lower forearm (gauntlet)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1275.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44970","name":"Laparoscopy appendectomy","description":"Laparoscopy, surgical, appendectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63180","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59430","name":"Care after delivery","description":"Postpartum care only (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35271","name":"Rpr blvs gr ot/th vn ntrth w","description":"Repair blood vessel with graft other than vein; intrathoracic, with bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12046","name":"Intmd rpr n-hf/genit20.1-30","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 20.1 cm to 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43240","name":"Egd w/transmural drain cyst","description":"Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheter[s]/stent[s], when performed, and endoscopic ultrasound, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92240","name":"Icg angiography i&r uni/bi","description":"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99420","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66179","name":"Aqueous shunt eye w/o graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93981","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35695","name":"Art trnsposj carotid subclav","description":"Transposition and/or reimplantation; carotid to subclavian artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":904.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3311.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61210","name":"Burr hole implt ventr cath","description":"Burr hole(s); for implanting ventricular catheter, reservoir, eeg electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86632","name":"Chlamydia igm antibody","description":"Antibody; chlamydia, igm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473T","name":"Reprgrmg io rta eltrd ra","description":"Device evaluation and interrogation of intraocular retinal electrode array (eg, retinal prosthesis), in person, including reprogramming and visual training, when performed, with review and report by a qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00934","name":"Anes rad amp penis ingun lym","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal lymphadenectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97530","name":"Therapeutic activities","description":"Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35632","name":"Bpg ilio-celiac","description":"Bypass graft, with other than vein; ilio-celiac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1598.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96112","name":"Devel tst phys/qhp 1st hr","description":"Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99446","name":"Ntrprof ph1/ntrnet/ehr 5-10","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15151.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21936","name":"Resect back tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1220.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33401","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96423","name":"Chemo ia infuse each addl hr","description":"Chemotherapy administration, intra-arterial; infusion technique, each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87498","name":"Enterovirus probe&revrs trns","description":"Infectious agent detection by nucleic acid (dna or rna); enterovirus, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74230","name":"X-ray xm swlng funcj c+","description":"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88385","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","name":"Anes trurl px urtrl cal rmvl","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"Psytx w pt 30 minutes","description":"Psychotherapy, 30 minutes with patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1751.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3214","name":"Benesch boot pair junior","description":"Benesch boot, pair, junior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31584","name":"Laryngoplasty fx rdctj fixj","description":"Laryngoplasty; with open reduction and fixation of (eg, plating) fracture, includes tracheostomy, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78473","name":"Gated heart multiple","description":"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63086","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","name":"Anes spine manipulation","description":"Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92341","name":"Fit spectacles bifocal","description":"Fitting of spectacles, except for aphakia; bifocal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25450","name":"Epiphysl arrst dstl rds/ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius or ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59130","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; abdominal pregnancy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92134","name":"Cptrz oph dx img pst sgm rta","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22904","name":"Radical resect abd tumor<5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31505","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, indirect; diagnostic (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93455","name":"Coronary art/grft angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85461","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; rosette","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27050","name":"Biopsy of sacroiliac joint","description":"Arthrotomy, with biopsy; sacroiliac joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98971","name":"Nqhp ol dig assmt&mgmt 11-20","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16384.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27252","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50542","name":"Laparo ablate renal mass","description":"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","name":"Anes opn/arthr elb tot rplct","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92012","name":"Intrm oph exam est patient","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61885","name":"Insrt/redo neurostim 1 array","description":"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33746","name":"Tis cgen car anomal ea addl","description":"Transcatheter intracardiac shunt (tis) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35663","name":"Bpg ilioiliac","description":"Bypass graft, with other than vein; ilioiliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33824","name":"Repair pda div 18 yrs&older","description":"Repair of patent ductus arteriosus; by division, 18 years and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1022.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37197","name":"Remove intrvas foreign body","description":"Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter), includes radiological supervision and interpretation, and imaging guidance (ultrasound or fluoroscopy), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20600","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35616","name":"Bpg subclavian-axillary","description":"Bypass graft, with other than vein; subclavian-axillary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78591","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15151.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83912","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0005","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; group counseling by a clinician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99219","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47630","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19298","name":"Place breast rad tube/caths","description":"Placement of radiotherapy after loading brachytherapy catheters (multiple tube and button type) into the breast for interstitial radioelement application following (at the time of or subsequent to) partial mastectomy, includes imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63685","name":"Ins/rplc spi npg/rcvr pocket","description":"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26215","name":"Remove/graft finger lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47700","name":"Exploration of bile ducts","description":"Exploration for congenital atresia of bile ducts, without repair, with or without liver biopsy, with or without cholangiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24220","name":"Injection px for elbow arthg","description":"Injection procedure for elbow arthrography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26372","name":"Repair/graft hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; secondary with free graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"Psych diagnostic evaluation","description":"Psychiatric diagnostic evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0239","name":"Oth resp proc, group","description":"Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33606","name":"Anastomosis/artery-aorta","description":"Anastomosis of pulmonary artery to aorta (damus-kaye-stansel procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86235","name":"Nuclear antigen antibody","description":"Extractable nuclear antigen, antibody to, any method (eg, nrnp, ss-a, ss-b, sm, rnp, sc170, j01), each antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55840","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6702.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86703","name":"Hiv-1/hiv-2 1 result antbdy","description":"Antibody; hiv-1 and hiv-2, single result","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38382","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","name":"Anes px art knee&pop nos","description":"Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25301","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; extensors of fingers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0172T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38242","name":"Transplt allo lymphocytes","description":"Allogeneic lymphocyte infusions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4211","name":"Supp for self-adm injections","description":"Supplies for self-administered injections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36835","name":"Insertion thomas shunt","description":"Insertion of thomas shunt (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P3001","name":"Screening pap smear by phys","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23474","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1480.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42804","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, visible lesion, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","name":"Anes integ sys conv arrhyt","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65125","name":"Revise ocular implant","description":"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2325.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88245","name":"Chromosome analysis 20-25","description":"Chromosome analysis for breakage syndromes; baseline sister chromatid exchange (sce), 20-25 cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82390","name":"Assay of ceruloplasmin","description":"Ceruloplasmin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36620","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66150","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trephination with iridectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27200","name":"Treat tail bone fracture","description":"Closed treatment of coccygeal fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76536","name":"Us exam of head and neck","description":"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12045","name":"Intmd rpr n-hf/genit12.6-20","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1608.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":652.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59821","name":"Treatment of miscarriage","description":"Treatment of missed abortion, completed surgically; second trimester","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512T","name":"Esw integ wnd hlg 1st wnd","description":"Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; initial wound","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15361","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93318","name":"Echo transesophageal intraop","description":"Echocardiography, transesophageal (tee) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20697","name":"App mltpln uni xtrnl fix xch","description":"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43130","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44390","name":"Colonoscopy for foreign body","description":"Colonoscopy through stoma; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97110","name":"Therapeutic exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93892","name":"Tcd emboli detect w/o inj","description":"Transcranial doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78710","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24640","name":"Cltx rdl head sublxtj nrsemd","description":"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28200","name":"Repair of foot tendon","description":"Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92524","name":"Behavral qualit analys voice","description":"Behavioral and qualitative analysis of voice and resonance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66175","name":"Trluml dil aq o/f can w/st","description":"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); with retention of device or stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26530","name":"Revise knuckle joint","description":"Arthroplasty, metacarpophalangeal joint; each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89329","name":"Sperm evaluation test","description":"Sperm evaluation; hamster penetration test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27257","name":"Treat hip dislocation","description":"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; with manipulation, requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2248.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81443","name":"Genetic tstg severe inh cond","description":"Genetic testing for severe inherited conditions (eg, cystic fibrosis, ashkenazi jewish-associated disorders [eg, bloom syndrome, canavan disease, fanconi anemia type c, mucolipidosis type vi, gaucher disease, tay-sachs disease], beta hemoglobinopathies, phenylketonuria, galactosemia), genomic sequen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1224.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86789","name":"West nile virus antibody","description":"Antibody; west nile virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27035","name":"Denervation of hip joint","description":"Denervation, hip joint, intrapelvic or extrapelvic intra-articular branches of sciatic, femoral, or obturator nerves","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69436","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12014","name":"Rpr f/e/e/n/l/m 5.1-7.5 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82638","name":"Assay of dibucaine number","description":"Dibucaine number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2995.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2625.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4536","name":"Reusable pull-on any size","description":"Incontinence product, protective underwear/pull-on, reusable, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97010","name":"Hot or cold packs therapy","description":"Application of a modality to 1 or more areas; hot or cold packs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59821","name":"Treatment of miscarriage","description":"Treatment of missed abortion, completed surgically; second trimester","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31785","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93890","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57106","name":"Vagnc prtl rmvl vag wall","description":"Vaginectomy, partial removal of vaginal wall;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41155","name":"Tongue jaw & neck surgery","description":"Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and radical neck dissection (commando type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2332.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33955","name":"Ecmo/ecls insj ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86648","name":"Diphtheria antibody","description":"Antibody; diphtheria","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23331","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69715","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43888","name":"Gstr rstcv px opn rmvl&rplc","description":"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93018","name":"Cv stress test i&r only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1768.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41000","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67930","name":"Repair eyelid wound","description":"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82746","name":"Assay of folic acid serum","description":"Folic acid; serum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26485","name":"Transplant palm tendon","description":"Transfer or transplant of tendon, palmar; without free tendon graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","name":"Emergency dept visit hi mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62287","name":"Dcmprn pq nuc pul 1/mlt lmbr","description":"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with discography and/or epidural injection(s) at the treated level(s), when performed, sing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43840","name":"Gstrrphy sutr duol/gstr ulcr","description":"Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1136.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80186","name":"Assay of phenytoin free","description":"Phenytoin; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2244.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27654","name":"Repair of achilles tendon","description":"Repair, secondary, achilles tendon, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00934","name":"Anes rad amp penis ingun lym","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal lymphadenectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67904","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91012","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46285","name":"Remove anal fist 2 stage","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43227","name":"Esophagoscopy control bleed","description":"Esophagoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"Off/op consltj new/est sf 20","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95707","name":"Eeg w/o vid 2-12hr cont mntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, 2-12 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87537","name":"Hiv-2 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-2, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58805","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92537","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22586","name":"Arthrd pre-sac ntrbdy l5-s1","description":"Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, l5-s1 interspace","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1848.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29584","name":"Appl mltlay cmprn sys up arm","description":"Application of multi-layer compression system; upper arm, forearm, hand, and fingers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0604","name":"Hosp grade elec breast pump","description":"Breast pump, hospital grade, electric (ac and / or dc), any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0880","name":"Pwc gp4 vhd sing pow opt s/b","description":"Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45123","name":"Partial proctectomy","description":"Proctectomy, partial, without anastomosis, perineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98961","name":"Edu&trn pt slf-mgmt nqhp 2-4","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 2-4 patients","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53621","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","name":"Anes all px nrv musc upr leg","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71023","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93720","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62000","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; simple, extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26262","name":"Resect distal finger tumor","description":"Radical resection of tumor, distal phalanx of finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85337","name":"Thrombomodulin","description":"Thrombomodulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25909","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; re-amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39561","name":"Resect diaphragm complex","description":"Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28510","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6024","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17261","name":"Dstrj mal les t/a/l .6-1.0cm","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38747","name":"Remove abdominal lymph nodes","description":"Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33745","name":"Tis cgen car anomal 1st shnt","description":"Transcatheter intracardiac shunt (tis) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77772","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27080","name":"Removal of tail bone","description":"Coccygectomy, primary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21347","name":"Opn tx nasomax fx multple","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); requiring multiple open approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26433","name":"Repair finger tendon","description":"Repair of extensor tendon, distal insertion, primary or secondary; without graft (eg, mallet finger)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83090","name":"Assay of homocysteine","description":"Homocysteine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27096","name":"Inject sacroiliac joint","description":"Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or ct) including arthrography when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63250","name":"Revise spinal cord vsls crvl","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2742.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11786.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27556","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; without primary ligamentous repair or augmentation/reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76828","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27005","name":"Tenotomy hip flexor open","description":"Tenotomy, hip flexor(s), open (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27499","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, multiple compartments; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21620","name":"Ostectomy sternum partial","description":"Ostectomy of sternum, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1893","name":"Intro/sheath, fixed,non-peel","description":"Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40654","name":"Rpr lip fth>1half ver ht/cpx","description":"Repair lip, full thickness; over one-half vertical height, or complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90815","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21123","name":"Geniop sldg augmentation","description":"Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36512","name":"Apheresis rbc","description":"Therapeutic apheresis; for red blood cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27356","name":"Remove femur lesion/graft","description":"Excision or curettage of bone cyst or benign tumor of femur; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89190","name":"Nasal smear for eosinophils","description":"Nasal smear for eosinophils","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10359.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15275","name":"Skin sub graft face/nk/hf/g","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44392","name":"Colonoscopy & polypectomy","description":"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33235","name":"Removal pacemaker electrode","description":"Removal of transvenous pacemaker electrode(s); dual lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1097.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28054","name":"Biopsy of toe joint lining","description":"Arthrotomy with biopsy; interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80402","name":"Acth stimulation panel","description":"Acth stimulation panel; for 21 hydroxylase deficiency this panel must include the following: cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10028.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27147","name":"Revision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone; with open reduction of hip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1243.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3437.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65710","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); anterior lamellar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97039","name":"Unlisted modality","description":"Unlisted modality (specify type and time if constant attendance)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62365","name":"Remove spine infusion device","description":"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67971","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74174","name":"Cta abd&plvs w/contrast","description":"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89220","name":"Sputum specimen collection","description":"Sputum, obtaining specimen, aerosol induced technique (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40800","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50810","name":"Fusion of ureter & bowel","description":"Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93657","name":"Tx l/r atrial fib addl","description":"Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","name":"Anes art sho&ax ax-brch arsm","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32851","name":"Lung transplant single","description":"Lung transplant, single; without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2632.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60281","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus; recurrent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28250","name":"Revision of foot fascia","description":"Division of plantar fascia and muscle (eg, steindler stripping) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":395.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77055","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81413","name":"Car ion chnnlpath inc 10 gns","description":"Cardiac ion channelopathies (eg, brugada syndrome, long qt syndrome, short qt syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing of at least 10 genes, including ank2, casq2, cav3, kcne1, kcne2, kcnh2, kcnj2, kcnq1, ryr2, and scn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19281","name":"Perq device breast 1st imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55840","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47147","name":"Prep donor liver/arterial","description":"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0399","name":"Home sleep test/type 3 porta","description":"Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0237","name":"Therapeutic procd strg endur","description":"Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61340","name":"Subtemporal cranial dcmprn","description":"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1314.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69710","name":"Implant/replace hearing aid","description":"Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24515","name":"Optx humrl shft fx plate/scr","description":"Open treatment of humeral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31511","name":"Remove foreign body larynx","description":"Laryngoscopy, indirect; with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93264","name":"Rem mntr wrls p-art prs snr","description":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days, including at least weekly downloads of pulmonary artery pressure recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99453","name":"Rem mntr physiol param setup","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); initial set-up and patient education on use of equipment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64802","name":"Sympathectomy cervical","description":"Sympathectomy, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24340","name":"Tenodesis biceps tdn at elbw","description":"Tenodesis of biceps tendon at elbow (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43310","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3875.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62140","name":"Crnop skull defect<5 cm diam","description":"Cranioplasty for skull defect; up to 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5160.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95921","name":"Autonomic nrv parasym inervj","description":"Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded r-r interval, valsalva ratio, and 30:15 ratio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54865","name":"Explore epididymis","description":"Exploration of epididymis, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50431","name":"Njx px nfrosgrm &/urtrgrm","description":"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2796.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65785","name":"Impltj ntrstrml crnl rng seg","description":"Implantation of intrastromal corneal ring segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0121","name":"Colon ca scrn not hi rsk ind","description":"Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","53"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38222","name":"Dx bone marrow bx & aspir","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0318","name":"Prolong home eval add 15m","description":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1276.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35889.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82438","name":"Assay other fluid chlorides","description":"Chloride; other source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27881","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula; with immediate fitting technique including application of first cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64782","name":"Remove limb nerve lesion","description":"Excision of neuroma; hand or foot, except digital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73718","name":"Mri lower extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29566.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71021","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31380","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); anterovertical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","name":"Anes upr gi ndsc px nos","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84085","name":"Assay of rbc pg6d enzyme","description":"Phosphogluconate, 6-, dehydrogenase, rbc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64861","name":"Repair of arm nerves","description":"Suture of; brachial plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1380.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67800","name":"Remove eyelid lesion","description":"Excision of chalazion; single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93232","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98929","name":"Osteopath manj 9-10 regions","description":"Osteopathic manipulative treatment (omt); 9-10 body regions involved","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28220","name":"Release of foot tendon","description":"Tenolysis, flexor, foot; single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28240","name":"Release of big toe","description":"Tenotomy, lengthening, or release, abductor hallucis muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82016","name":"Acylcarnitines qual","description":"Acylcarnitines; qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36838","name":"Dist revas ligation hemo","description":"Distal revascularization and interval ligation (dril), upper extremity hemodialysis access (steal syndrome)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71270","name":"Ct thorax dx c-/c+","description":"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92285","name":"External ocular photography","description":"External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59150","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26742","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24400","name":"Osteot humerus w/wo int fixj","description":"Osteotomy, humerus, with or without internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43265","name":"Ercp lithotripsy calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0151T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34713","name":"Perq access & clsr fem art","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 french or larger), including ultrasound guidance, when performed, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95873","name":"Guide nerv destr elec stim","description":"Electrical stimulation for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2796.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27486","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; 1 component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25031","name":"I&d forearm&/wrist bursa","description":"Incision and drainage, forearm and/or wrist; bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52402","name":"Cysto trurl rescj ejacul dux","description":"Cystourethroscopy with transurethral resection or incision of ejaculatory ducts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28126","name":"Partial removal of toe","description":"Resection, partial or complete, phalangeal base, each toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50525","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54840","name":"Remove epididymis lesion","description":"Excision of spermatocele, with or without epididymectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21141","name":"Rcnstj midface lefort i 1pc","description":"Reconstruction midface, lefort i; single piece, segment movement in any direction (eg, for long face syndrome), without bone graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1068.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","name":"Anes hernia repair<1 yr age","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, younger than 1 year of age","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87562","name":"M.avium-intra dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41822","name":"Excision of gum lesion","description":"Excision of fibrous tuberosities, dentoalveolar structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28118","name":"Removal of heel bone","description":"Ostectomy, calcaneus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44227","name":"Lap close enterostomy","description":"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1372.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21552","name":"Exc neck les sc 3 cm/>","description":"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99379","name":"Nursing fac care supervision","description":"Supervision of a nursing facility patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, comm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65800","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58925","name":"Removal of ovarian cyst(s)","description":"Ovarian cystectomy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64462","name":"Pvb thoracic 2nd+ inj site","description":"Paravertebral block (pvb) (paraspinous block), thoracic; second and any additional injection site(s) (includes imaging guidance, when performed) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87206","name":"Smear fluorescent/acid stai","description":"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73702","name":"Ct lwr extremity w/o&w/dye","description":"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12006","name":"Rpr s/n/a/gen/trk20.1-30.0cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22902","name":"Exc abd les sc < 3 cm","description":"Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62220","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-atrial, -jugular, -auricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67113","name":"Repair retinal detach cplx","description":"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage c-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamp","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73220","name":"Mri uppr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11983","name":"Remove/insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99324","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92521","name":"Evaluation of speech fluency","description":"Evaluation of speech fluency (eg, stuttering, cluttering)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3546.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90671","name":"Pcv15 vaccine im","description":"Pneumococcal conjugate vaccine, 15 valent (pcv15), for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3152.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92315","name":"C-lens fitg tech aphakia 1","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, 1 eye","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12001","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33330","name":"Insert major vessel graft","description":"Insertion of graft, aorta or great vessels; without shunt, or cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1234.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82627","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone-sulfate (dhea-s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42106","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with simple primary closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":237.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12044","name":"Intmd rpr n-hf/genit7.6-12.5","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26554","name":"Double transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, double","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3235.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38520","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83903","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97165","name":"Ot eval low complex 30 min","description":"Occupational therapy evaluation, low complexity, requiring these components: an occupational profile and medical and therapy history, which includes a brief history including review of medical and/or therapy records relating to the presenting problem; an assessment(s) that identifies 1-3 performance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15829","name":"Rhytidectomy smas flap","description":"Rhytidectomy; superficial musculoaponeurotic system (smas) flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83914","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63081","name":"Remove vert body dcmprn crvl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1568.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45347","name":"Sigmoidoscopy w/plcmt stent","description":"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0288","name":"Recon, cta for surg plan","description":"Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93456","name":"R hrt coronary artery angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84377","name":"Sugars multiple qual","description":"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58575","name":"Laps tot hyst resj mal","description":"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27282","name":"Arthrodesis symphysis pubis","description":"Arthrodesis, symphysis pubis (including obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0309","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45135","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; abdominal and perineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92508","name":"Tx sp lang voice comm group","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93893","name":"Tcd std icr art ven-art shnt","description":"Transcranial doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36514","name":"Apheresis plasma","description":"Therapeutic apheresis; for plasma pheresis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11055","name":"Paring/cutg b9 hyprker les 1","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4855.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28120","name":"Part removal of ankle/heel","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); talus or calcaneus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2617","name":"Custom fab w/c back cushion","description":"Custom fabricated wheelchair back cushion, any size, including any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46946","name":"Int hrhc lig 2+hroid w/o img","description":"Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56634","name":"Vlvctmy rad comp uni lymphad","description":"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87118","name":"Mycobacteric identification","description":"Culture, mycobacterial, definitive identification, each isolate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20962","name":"Other bone graft microvasc","description":"Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2254.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40701","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93287","name":"Peri-px device eval & prgr","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48155.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76983","name":"Use ea addl target lesion","description":"Ultrasound, elastography; each additional target lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90849","name":"Multiple family group psytx","description":"Multiple-family group psychotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1860.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87040","name":"Blood culture for bacteria","description":"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92502","name":"Ear and throat examination","description":"Otolaryngologic examination under general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93641","name":"Ep evl 1/2chmb pac cvdfb tst","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99173","name":"Visual acuity screen","description":"Screening test of visual acuity, quantitative, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35256","name":"Repair blvsl vn grf lxtr","description":"Repair blood vessel with vein graft; lower extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26116","name":"Exc hand tum deep < 1.5 cm","description":"Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); less than 1.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76376","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81274","name":"Htt gene charac alleles","description":"Htt (huntingtin) (eg, huntington disease) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54344","name":"Rrp hypspad comp moblj&urtp","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28222","name":"Release of foot tendons","description":"Tenolysis, flexor, foot; multiple tendons","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3415.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","name":"Anes th ivnt rad ntrthrc/jug","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21502","name":"I&d dp abs/hmtm nck rib ostc","description":"Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax; with partial rib ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43420","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42971","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64786","name":"Remove sciatic nerve lesion","description":"Excision of neuroma; sciatic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12021","name":"Tx supfc wnd dehsn w/packing","description":"Treatment of superficial wound dehiscence; with packing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68326","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01520","name":"Anes px veins lower leg nos","description":"Anesthesia for procedures on veins of lower leg; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11922","name":"Correct skin color ea 20.0cm","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; each additional 20.0 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47785","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of intrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2726.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3001.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3415.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62160","name":"Neuroendoscopy add-on","description":"Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61850","name":"Implant neuroelectrodes","description":"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57111","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58540","name":"Revision of uterus","description":"Hysteroplasty, repair of uterine anomaly (strassman type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47531","name":"Injection for cholangiogram","description":"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64834","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; hand or foot, common sensory nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0201T","name":"Perq sacral augmt bilat inj","description":"Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, 2 or more needles, includes imaging guidance and bone biopsy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97532","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15769","name":"Grfg autol soft tiss dir exc","description":"Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73720","name":"Mri lwr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74245","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83625","name":"Assay of ldh enzymes","description":"Lactate dehydrogenase (ld), (ldh); isoenzymes, separation and quantitation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97035","name":"App mdlty 1+ultrasound ea 15","description":"Application of a modality to 1 or more areas; ultrasound, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2335.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4895.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26546","name":"Repair nonunion hand","description":"Repair non-union, metacarpal or phalanx (includes obtaining bone graft with or without external or internal fixation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86666","name":"Ehrlichia antibody","description":"Antibody; ehrlichia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92584","name":"Electrocochleography","description":"Electrocochleography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50385","name":"Change stent via transureth","description":"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65820","name":"Goniotomy","description":"Goniotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95886","name":"Musc test done w/n test comp","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0518","name":"Remove w insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54015","name":"I&d penis deep","description":"Incision and drainage of penis, deep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27726","name":"Repair fibula nonunion","description":"Repair of fibula nonunion and/or malunion with internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32402","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93654","name":"Compre ep eval tx vt","description":"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording and catheter ablation of arrhythmogenic focus, including intracardiac electrophysiologic 3-dimensiona","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92625","name":"Tinnitus assessment","description":"Assessment of tinnitus (includes pitch, loudness matching, and masking)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63702","name":"Repair of spinal herniation","description":"Repair of meningocele; larger than 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1297.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84081","name":"Assay phosphatidylglycerol","description":"Phosphatidylglycerol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87430","name":"Strep a ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; streptococcus, group a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76497","name":"Unlisted ct procedure","description":"Unlisted computed tomography procedure (eg, diagnostic, interventional)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88107","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61692","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3392.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11300","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22612","name":"Arthrd pst tq 1ntrspc lumbar","description":"Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1394.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80074","name":"Acute hepatitis panel","description":"Acute hepatitis panel this panel must include the following: hepatitis a antibody (haab), igm antibody (86709) hepatitis b core antibody (hbcab), igm antibody (86705) hepatitis b surface antigen (hbsag) (87340) hepatitis c antibody (86803)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2009","name":"Post-d/c h vst ext pt 60 m","description":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatien","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86732","name":"Mucormycosis antibody","description":"Antibody; mucormycosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24200","name":"Rmvl fb upper arm/elbw subq","description":"Removal of foreign body, upper arm or elbow area; subcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42220","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; secondary lengthening procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54220","name":"Irrg crpra cavrnosa priapism","description":"Irrigation of corpora cavernosa for priapism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22818","name":"Kyphectomy 1-2 segments","description":"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); single or 2 segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19368","name":"Brst rcnstj 1pdcl tram anast","description":"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (tram) flap, requiring separate microvascular anastomosis (supercharging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1417.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47010","name":"Hepatot opn drg absc/cst 1/2","description":"Hepatotomy, for open drainage of abscess or cyst, 1 or 2 stages","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78804","name":"Rp loclzj tum whbdy 2+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","name":"Anes integ sys rad/modf brst","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98929","name":"Osteopath manj 9-10 regions","description":"Osteopathic manipulative treatment (omt); 9-10 body regions involved","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56440","name":"Mrsplzatn brthlns glnd cst","description":"Marsupialization of bartholins gland cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31535","name":"Laryngoscopy w/biopsy","description":"Laryngoscopy, direct, operative, with biopsy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82360","name":"Calculus assay quant","description":"Calculus; quantitative analysis, chemical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97010","name":"Hot or cold packs therapy","description":"Application of a modality to 1 or more areas; hot or cold packs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1991.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88361","name":"Tumor immunohistochem/comput","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29835","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72158","name":"Mri lumbar spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34802","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1056.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96910","name":"Photchmtx tar&uvb/ptrltm&uvb","description":"Photochemotherapy; tar and ultraviolet b (goeckerman treatment) or petrolatum and ultraviolet b","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46607","name":"Diagnostic anoscopy & biopsy","description":"Anoscopy; with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86723","name":"Listeria monocytogenes","description":"Antibody; listeria monocytogenes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50340","name":"Recipient nephrectomy","description":"Recipient nephrectomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73222","name":"Mri joint upr extrem w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2324.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85378","name":"Fibrin degrade semiquant","description":"Fibrin degradation products, d-dimer; qualitative or semiquantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26852","name":"Fusion of knuckle with graft","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4230","name":"Infus insulin pump non needl","description":"Infusion set for external insulin pump, non needle cannula type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21315","name":"Clsd tx nsl fx mnpj wo stblj","description":"Closed treatment of nasal bone fracture with manipulation; without stabilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50380","name":"Rnl autotrnsplj rimpltj kdn","description":"Renal autotransplantation, reimplantation of kidney","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1753.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15772","name":"Grfg autol fat lipo ea addl","description":"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; each additional 50 cc injectate, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5764.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20900","name":"Removal of bone for graft","description":"Bone graft, any donor area; minor or small (eg, dowel or button)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67221","name":"Ocular photodynamic ther","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28262","name":"Revision of foot and ankle","description":"Capsulotomy, midfoot; extensive, including posterior talotibial capsulotomy and tendon(s) lengthening (eg, resistant clubfoot deformity)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61867","name":"Implant neuroelectrode","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2092.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43450","name":"Dilate esophagus 1/mult pass","description":"Dilation of esophagus, by unguided sound or bougie, single or multiple passes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1587.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82380","name":"Assay of carotene","description":"Carotene","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33460","name":"Revision of tricuspid valve","description":"Valvectomy, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64647","name":"Chemodenerv trunk musc 6/>","description":"Chemodenervation of trunk muscle(s); 6 or more muscles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19297","name":"Place breast cath for rad","description":"Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22100","name":"Remove part of neck vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36460","name":"Intrauterine transfusion ftl","description":"Transfusion, intrauterine, fetal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71270","name":"Ct thorax dx c-/c+","description":"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1831.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54405","name":"Insert multi-comp penis pros","description":"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95803","name":"Actigraphy testing","description":"Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92532","name":"Positional nystagmus test","description":"Positional nystagmus test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46922","name":"Excision of anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","name":"Anes px heart w/o pump oxtj","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","name":"Anes hrna rpr<37wk brth<50","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92577","name":"Stenger test speech","description":"Stenger test, speech","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28024","name":"Exploration of toe joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75940","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69540","name":"Excision aural polyp","description":"Excision aural polyp","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15366","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94260","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82103","name":"Alpha-1-antitrypsin total","description":"Alpha-1-antitrypsin; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96118","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15841","name":"Nerve palsy muscle graft","description":"Graft for facial nerve paralysis; free muscle graft (including obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0071","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83071","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31611","name":"Constj trachesophgl fstl","description":"Construction of tracheoesophageal fistula and subsequent insertion of an alaryngeal speech prosthesis (eg, voice button, blom-singer prosthesis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64716","name":"Revision of cranial nerve","description":"Neuroplasty and/or transposition; cranial nerve (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27360","name":"Partial removal leg bone(s)","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone, femur, proximal tibia and/or fibula (eg, osteomyelitis or bone abscess)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72148","name":"Mri lumbar spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82085","name":"Assay of aldolase","description":"Aldolase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88112","name":"Cytopath cell enhance tech","description":"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86817","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, multiple antigens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4266","name":"Diaphragm","description":"Diaphragm for contraceptive use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46261","name":"Remove in/ex hem grps & fiss","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94727","name":"Gas dil/wshot deter lng vol","description":"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24342","name":"Repair of ruptured tendon","description":"Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92538","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24360","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with membrane (eg, fascial)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23400","name":"Fixation of shoulder blade","description":"Scapulopexy (eg, sprengels deformity or for paralysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33305","name":"Repair of heart wound","description":"Repair of cardiac wound; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3585.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33274","name":"Tcat insj/rpl perm ldls pm","description":"Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33262","name":"Rmvl& replc pulse gen 1 lead","description":"Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; single lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87118","name":"Mycobacteric identification","description":"Culture, mycobacterial, definitive identification, each isolate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56637","name":"Vlvctmy rad comp bi lymphad","description":"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25830","name":"Arthrd dst rad/ul jt sgm rsc","description":"Arthrodesis, distal radioulnar joint with segmental resection of ulna, with or without bone graft (eg, sauve-kapandji procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31786","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","name":"Anes hernia repair<1 yr age","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, younger than 1 year of age","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76125","name":"Cine/video x-rays add-on","description":"Cineradiography/videoradiography to complement routine examination (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83527","name":"Assay of insulin","description":"Insulin; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0102T","name":"Esw phy anes lat hmrl epcndl","description":"Extracorporeal shock wave performed by a physician, requiring anesthesia other than local, and involving the lateral humeral epicondyle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28297","name":"Cor hlx vlgs jt arthrd","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86431","name":"Rheumatoid factor quant","description":"Rheumatoid factor; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92286","name":"Ant sgm img i&r speclr mic","description":"Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62263","name":"Epidural lysis mult sessions","description":"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 2 or more days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27222","name":"Treat hip socket fracture","description":"Closed treatment of acetabulum (hip socket) fracture(s); with manipulation, with or without skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57307","name":"Fistula repair & colostomy","description":"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28446","name":"Opn osteochondrl agrft talus","description":"Open osteochondral autograft, talus (includes obtaining graft[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21076","name":"Impres&prep surg obt prosth","description":"Impression and custom preparation; surgical obturator prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24546","name":"Optx hum fx w/ntrcndylr xtn","description":"Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; with intercondylar extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L0430","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37244","name":"Vasc embolize/occlude bleed","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial or venous hemorrhage or lymphatic extravasation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21705","name":"Revision of neck muscle/rib","description":"Division of scalenus anticus; with resection of cervical rib","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8879.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73522","name":"X-ray exam hips bi 3-4 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16020","name":"Dress/debrid p-thick burn s","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7830.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51728","name":"Cystometrogram w/vp","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27305","name":"Incise thigh tendon & fascia","description":"Fasciotomy, iliotibial (tenotomy), open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21016","name":"Resect face/scalp tum 2 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; 2 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86729","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45327","name":"Proctosigmoidoscopy w/stent","description":"Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90911","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54120","name":"Partial removal of penis","description":"Amputation of penis; partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82308","name":"Assay of calcitonin","description":"Calcitonin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32905","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95886","name":"Musc test done w/n test comp","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52281","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58951","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93230","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4508.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88350","name":"Imfluor ea addl 1antb stn px","description":"Immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KM","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33264","name":"Rmvl & rplcmt dfb gen mlt ld","description":"Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50386","name":"Remove stent via transureth","description":"Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51729","name":"Cystometrogram w/vp&up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","name":"Anes px nrv musc upr a&e nos","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93290","name":"Interrog dev eval icpms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular physiologic monitor system, including analysis of 1 or more reco","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55650","name":"Remove sperm duct pouch","description":"Vesiculectomy, any approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65285","name":"Repair of eye wound","description":"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23410","name":"Repair rotator cuff acute","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88368","name":"Insitu hybridization manual","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85097","name":"Bone marrow interpretation","description":"Bone marrow, smear interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78454","name":"Ht musc image planar mult","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87503","name":"Influenza dna amp prob addl","description":"Infectious agent detection by nucleic acid (dna or rna); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, each additional influenza virus type or sub-type beyond 2 (list separately in addition to code","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64447","name":"Njx aa&/strd femoral nrv img","description":"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20955","name":"Fibula bone graft microvasc","description":"Bone graft with microvascular anastomosis; fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2031.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62263","name":"Epidural lysis mult sessions","description":"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 2 or more days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23210","name":"Radical rescj tumor scapula","description":"Radical resection of tumor; scapula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49400","name":"Air injection into abdomen","description":"Injection of air or contrast into peritoneal cavity (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87902","name":"Nfct agt gntyp alys hep c","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hepatitis c virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36479","name":"Endovenous laser vein addon","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7234.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38542","name":"Explore deep node(s) neck","description":"Dissection, deep jugular node(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93508","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4510","name":"Full length surg stocking","description":"Surgical stockings full length, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20808","name":"Replantation hand complete","description":"Replantation, hand (includes hand through metacarpophalangeal joints), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40720","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32674","name":"Thoracoscopy lymph node exc","description":"Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75952","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61070","name":"Brain canal shunt procedure","description":"Puncture of shunt tubing or reservoir for aspiration or injection procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96374","name":"Ther/proph/diag inj iv push","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48551","name":"Prep donor pancreas","description":"Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile duct, ligation of mesenteric vessels, and y-graft arterial anastomoses from iliac artery to superio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26675","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87591","name":"N.gonorrhoeae dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78802","name":"Rp loclzj tum whbdy 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37223","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76102","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34201","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":903.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4564.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83735","name":"Assay of magnesium","description":"Magnesium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33340","name":"Perq clsr tcat l atr apndge","description":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64484","name":"Njx aa&/strd tfrm epi l/s ea","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), lumbar or sacral, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6543","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78816","name":"Pet image w/ct full body","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1228.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27065","name":"Remove hip bone les super","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; superficial, includes autograft, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32562","name":"Lyse chest fibrin subq day","description":"Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); subsequent day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5976.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":211.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","name":"Anes integ sys rad/modf brst","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0879","name":"Pwc gp4 hd sing pow opt s/b","description":"Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1584.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4663","name":"Dialysis blood pressure cuff","description":"Blood pressure cuff only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89331","name":"Retrograde ejaculation anal","description":"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60502","name":"Re-explore parathyroids","description":"Parathyroidectomy or exploration of parathyroid(s); re-exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67040","name":"Laser treatment of retina","description":"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3249.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69725","name":"Release facial nerve","description":"Decompression facial nerve, intratemporal; including medial to geniculate ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1517.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92979","name":"Endoluminl ivus oct c ea","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to co","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99495","name":"Transj care mgmt mod f2f 14d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge at least moderate level of medical decision making during the service period face-to-face visit, wit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29730","name":"Windowing of cast","description":"Windowing of cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36901","name":"Intro cath dialysis circuit","description":"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous out","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33968","name":"Remove aortic assist device","description":"Removal of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68362","name":"Revise eyelid lining","description":"Conjunctival flap; total (such as gunderson thin flap or purse string flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93306","name":"Tte w/doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59612","name":"Vbac delivery only","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42405","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; incisional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0064","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88141","name":"Cytopath c/v interpret","description":"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","name":"Anes opn upr 2/3 fem rad res","description":"Anesthesia for open procedures involving upper two-thirds of femur; radical resection","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0109","name":"Diab manage trn ind/group","description":"Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34833","name":"Opn ilac art expos cndt crtj","description":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47740","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99335","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37217","name":"Stent placemt retro carotid","description":"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angioplasty, when performed, and radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28735","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61343","name":"Crnec sopl crv lam dcmprn","description":"Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, arnold-chiari malformation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2008.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64752","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47553","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88302","name":"Tissue exam by pathologist","description":"Level ii - surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incident","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2063","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76811","name":"Ob us detailed sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34832","name":"Open aortofemor prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bifemoral prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1676.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37765","name":"Stab phleb veins xtr 10-20","description":"Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94004","name":"Vent mgmt nf per day","description":"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; nursing facility, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37228","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12011","name":"Rpr f/e/e/n/l/m 2.5 cm/<","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33420","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; closed heart","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13121","name":"Cmplx rpr s/a/l 2.6-7.5 cm","description":"Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B5100","name":"Parenteral solution hepatic","description":"Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, hepatic, hepatamine-premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37660","name":"Ligation common iliac vein","description":"Ligation of common iliac vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78584","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88388","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11760","name":"Repair of nail bed","description":"Repair of nail bed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29902","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced ulnar collateral ligament (eg, stener lesion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0317","name":"Prolong nursin fac eval 15m","description":"Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77048","name":"Mri breast c-+ w/cad uni","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64448","name":"Njx aa&/strd fem nrv nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86880","name":"Coombs test direct","description":"Antihuman globulin test (coombs test); direct, each antiserum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15734","name":"Muscle-skin graft trunk","description":"Muscle, myocutaneous, or fasciocutaneous flap; trunk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73725","name":"Mr ang lwr ext w or w/o dye","description":"Magnetic resonance angiography, lower extremity, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3485","name":"Shoe heel pad removable for","description":"Heel, pad, removable for spur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1154.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93622","name":"Comp ep eval l ventr pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1808.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28308","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25515","name":"Optx radial shaft fracture","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1389.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":732.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"Prev med cnsl indiv apprx 15","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59855","name":"Induced abortion 1+vag supp","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96102","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87305","name":"Aspergillus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; aspergillus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57558","name":"D&c of cervical stump","description":"Dilation and curettage of cervical stump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95927","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33778","name":"Rpr tga aortic pulm art rcns","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2045.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30435","name":"Revision of nose","description":"Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","name":"Anes male gent rad orch ing","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87636","name":"Sarscov2 & inf a&b amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b, multiplex amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75945","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58270","name":"Vag hyst w/enterocele repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","name":"Anes px nrv msc upr a&e tnot","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP11","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23466","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, any type multidirectional instability","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66840","name":"Removal of lens material","description":"Removal of lens material; aspiration technique, 1 or more stages","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56640","name":"Vlvctmy rad comp w/lymphadec","description":"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33256","name":"Ablate atria w/bypass exten","description":"Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2055.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28344","name":"Repair extra toe(s)","description":"Reconstruction, toe(s); polydactyly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97814","name":"Acup 1/> w/estim ea addl 15","description":"Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","name":"Anes px crv spn&cord sitting","description":"Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82139","name":"Amino acids quan 6 or more","description":"Amino acids, 6 or more amino acids, quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58345","name":"Reopen fallopian tube","description":"Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15837","name":"Exc excsv skin forearm/hand","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67043","name":"Vit for membrane dissect","description":"Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and laser photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96445","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92973","name":"Prq trluml c mchn asp thrmbc","description":"Percutaneous transluminal coronary mechanical aspiration thrombectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87660","name":"Trichomonas vagin dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33215","name":"Reposition pacing-defib lead","description":"Repositioning of previously implanted transvenous pacemaker or implantable defibrillator (right atrial or right ventricular) electrode","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72082","name":"X-ray exam entire spi 2/3 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"Esrd home pt serv p mo <2yrs","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25265","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2440.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2528.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27265","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33225","name":"L ventric pacing lead add-on","description":"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28260","name":"Release of midfoot joint","description":"Capsulotomy, midfoot; medial release only (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20150","name":"Excision epiphyseal bar","description":"Excision of epiphyseal bar, with or without autogenous soft tissue graft obtained through same fascial incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52275","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; male","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15360","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58554","name":"Laparo-vag hyst w/t/o compl","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35903","name":"Excision graft extremity","description":"Excision of infected graft; extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41009","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82668","name":"Assay of erythropoietin","description":"Erythropoietin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","name":"Anes upr lwr gi ndsc px","description":"Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37184","name":"Prim art m-thrmbc 1st vsl","description":"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33602","name":"Closure of valve","description":"Closure of semilunar valve (aortic or pulmonary) by suture or patch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80194","name":"Assay of quinidine","description":"Quinidine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85547","name":"Rbc mechanical fragility","description":"Mechanical fragility, rbc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96171","name":"Hlth bhv ivntj fam w/o pt ea","description":"Health behavior intervention, family (without the patient present), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0079","name":"Care manag h vst new pt 60 m","description":"Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35901","name":"Excision graft neck","description":"Excision of infected graft; neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31577","name":"Largsc w/rmvl foreign bdy(s)","description":"Laryngoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43774","name":"Lap rmvl gastr adj all parts","description":"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33915","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1194.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":491.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1982.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":803.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26410","name":"Repair hand tendon","description":"Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24495","name":"Decompression fasct forearm","description":"Decompression fasciotomy, forearm, with brachial artery exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15940","name":"Exc ischial pr ulc prim sutr","description":"Excision, ischial pressure ulcer, with primary suture;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33468","name":"Revision of tricuspid valve","description":"Tricuspid valve repositioning and plication for ebstein anomaly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2136.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33767","name":"Shunt supr v/c p-art bth lng","description":"Shunt; superior vena cava to pulmonary artery for flow to both lungs (bidirectional glenn procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1234.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5475.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92273","name":"Full field erg w/i&r","description":"Electroretinography (erg), with interpretation and report; full field (ie, fferg, flash erg, ganzfeld erg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47147","name":"Prep donor liver/arterial","description":"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15750","name":"Neurovascular pedicle flap","description":"Flap; neurovascular pedicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95874","name":"Guide nerv destr needle emg","description":"Needle electromyography for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64886","name":"Nerve graft head/neck >4 cm","description":"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3617.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32141","name":"Remove/treat lung lesions","description":"Thoracotomy; with resection-plication of bullae, includes any pleural procedure when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5610.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3079.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33946","name":"Ecmo/ecls initiation venous","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-venous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T5001","name":"Position seat spec orth need","description":"Positioning seat for persons with special orthopedic needs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33216","name":"Insert 1 electrode pm-defib","description":"Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443T","name":"R-t spctrl alys prst8 tiss","description":"Real-time spectral analysis of prostate tissue by fluorescence spectroscopy, including imaging guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36228","name":"Place cath intracranial art","description":"Selective catheter placement, each intracranial branch of the internal carotid or vertebral arteries, unilateral, with angiography of the selected vessel circulation and all associated radiological supervision and interpretation (eg, middle cerebral artery, posterior inferior cerebellar artery) (lis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86641","name":"Cryptococcus antibody","description":"Antibody; cryptococcus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28202","name":"Repair/graft of foot tendon","description":"Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58321","name":"Artificial insemination","description":"Artificial insemination; intra-cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70480","name":"Ct orbit/ear/fossa w/o dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88309","name":"Tissue exam by pathologist","description":"Level vi - surgical pathology, gross and microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection extremity, disarticulation fetus, with dissection larynx, partial/total resect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26615","name":"Treat metacarpal fracture","description":"Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92604","name":"Reprogram cochlear implt 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27392","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53080","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; uncomplicated (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26706","name":"Pin knuckle dislocation","description":"Percutaneous skeletal fixation of metacarpophalangeal dislocation, single, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36483","name":"Endoven ther chem adhes sbsq","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53430","name":"Reconstruction of urethra","description":"Urethroplasty, reconstruction of female urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25426","name":"Repair/graft radius & ulna","description":"Repair of defect with autograft; radius and ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5480.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2887.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67208","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","name":"Anes maj lwr adb vsl ivc lig","description":"Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74174","name":"Cta abd&plvs w/contrast","description":"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0248","name":"Hdtrans bench w/wo comm open","description":"Transfer bench, heavy duty, for tub or toilet with or without commode opening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77373","name":"Strtctc bdy rad ther tx dlvr","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":976.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87905","name":"Ia nzmtc actv oth/thn virus","description":"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29000","name":"Appl halo type body cast","description":"Application of halo type body cast (see 20661-20663 for insertion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80402","name":"Acth stimulation panel","description":"Acth stimulation panel; for 21 hydroxylase deficiency this panel must include the following: cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54312","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57556","name":"Remove cervix repair bowel","description":"Excision of cervical stump, vaginal approach; with repair of enterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65782","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19103","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54135","name":"Remove penis & nodes","description":"Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1223.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44021","name":"Decompress small bowel","description":"Enterotomy, small intestine, other than duodenum; for decompression (eg, baker tube)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":5.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"Psytx w pt w e/m 45 min","description":"Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86406","name":"Particle agglut antbdy titr","description":"Particle agglutination; titer, each antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51865","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0072A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61480","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50555","name":"Kidney endoscopy & biopsy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58752","name":"Revise ovarian tube(s)","description":"Tubouterine implantation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88371","name":"Protein western blot tissue","description":"Protein analysis of tissue by western blot, with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26641","name":"Treat thumb dislocation","description":"Closed treatment of carpometacarpal dislocation, thumb, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88305","name":"Tissue exam by pathologist","description":"Level iv - surgical pathology, gross and microscopic examination abortion - spontaneous/missed artery, biopsy bone marrow, biopsy bone exostosis brain/meninges, other than for tumor resection breast, biopsy, not requiring microscopic evaluation of surgical margins breast, reduction mammoplasty bronc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26850","name":"Fusion of knuckle","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86793","name":"Yersinia antibody","description":"Antibody; yersinia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88264","name":"Chromosome analysis 20-25","description":"Chromosome analysis; analyze 20-25 cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52648","name":"Laser surgery of prostate","description":"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1352.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3415.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24650","name":"Cltx rdl head/nck fx wo mnpj","description":"Closed treatment of radial head or neck fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65920","name":"Remove implant of eye","description":"Removal of implanted material, anterior segment of eye","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85410","name":"Fibrinolytic antiplasmin","description":"Fibrinolytic factors and inhibitors; alpha-2 antiplasmin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87187","name":"Sc std microdil/agar mlc","description":"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (mlc), each plate (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44020","name":"Explore small intestine","description":"Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93227","name":"Xtrnl ecg rec<48 hr r&i","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27156","name":"Revision of hip bones","description":"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy and with open reduction of hip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43652","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","name":"Anes px vn lwr leg ven thrmb","description":"Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0154A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93623","name":"Prgrmd stimj&pacg iv rx nfs","description":"Programmed stimulation and pacing after intravenous drug infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3320","name":"Shoe lift elev heel/sole cor","description":"Lift, elevation, heel and sole, cork, per inch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9021","name":"Red blood cells unit","description":"Red blood cells, each unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35903","name":"Excision graft extremity","description":"Excision of infected graft; extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75658","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11641","name":"Exc f/e/e/n/l mal+mrg 0.6-1","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30430","name":"Revision of nose","description":"Rhinoplasty, secondary; minor revision (small amount of nasal tip work)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31365","name":"Removal of larynx","description":"Laryngectomy; total, with radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63055","name":"Decompress spinal cord thrc","description":"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1467.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27365","name":"Resect femur/knee tumor","description":"Radical resection of tumor, femur or knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27823","name":"Treatment of ankle fracture","description":"Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; with fixation of posterior lip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31725","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); tracheobronchial with fiberscope, bedside","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69535","name":"Remove part of temporal bone","description":"Resection temporal bone, external approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2141.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98961","name":"Edu&trn pt slf-mgmt nqhp 2-4","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 2-4 patients","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15792","name":"Chem peel nonfacial epidrm","description":"Chemical peel, nonfacial; epidermal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28605","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82240","name":"Bile acids cholylglycine","description":"Bile acids; cholylglycine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23101","name":"Arthrt acrmclv/strnclav jt","description":"Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28070","name":"Removal of foot joint lining","description":"Synovectomy; intertarsal or tarsometatarsal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50562","name":"Renal scope w/tumor resect","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93288","name":"Interrog evl pm/ldls pm ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system, or leadless pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8052.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73522","name":"X-ray exam hips bi 3-4 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41520","name":"Reconstruction tongue fold","description":"Frenoplasty (surgical revision of frenum, eg, with z-plasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1328.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24940","name":"Revision of upper arm","description":"Cineplasty, upper extremity, complete procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46611","name":"Anoscopy","description":"Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52001","name":"Cysto w/irrg&evac mlt clots","description":"Cystourethroscopy with irrigation and evacuation of multiple obstructing clots","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93580","name":"Transcath closure of asd","description":"Percutaneous transcatheter closure of congenital interatrial communication (ie, fontan fenestration, atrial septal defect) with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29025","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25651","name":"Perq skel fix ulnar styld fx","description":"Percutaneous skeletal fixation of ulnar styloid fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0473","name":"Group behave couns 2-10","description":"Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97533","name":"Sensory integration","description":"Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78072","name":"Parathyrd planar w/spect&ct","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect), and concurrently acquired computed tomography (ct) for anatomical localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61797","name":"Srs cran les simple addl","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27870","name":"Fusion of ankle joint open","description":"Arthrodesis, ankle, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4224.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26215","name":"Remove/graft finger lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71271","name":"Ct thorax lung cancer scr c-","description":"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3995.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11302","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2643.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60520","name":"Removal of thymus gland","description":"Thymectomy, partial or total; transcervical approach (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89322","name":"Semen anal strict criteria","description":"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, kruger)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31825","name":"Repair of windpipe defect","description":"Surgical closure tracheostomy or fistula; with plastic repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82055","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97802","name":"Medical nutrition indiv in","description":"Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81314","name":"Pdgfra gene","description":"Pdgfra (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor [gist]), gene analysis, targeted sequence analysis (eg, exons 12, 18)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7928.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76816","name":"Ob us follow-up per fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetu","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86635","name":"Coccidioides antibody","description":"Antibody; coccidioides","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88283","name":"Chromosome banding study","description":"Chromosome analysis; additional specialized banding technique (eg, nor, c-banding)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77432","name":"Stereotactic radiation trmt","description":"Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28606","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34812","name":"Opn fem art expos","description":"Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47741","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y with gastroenterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1237.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25920","name":"Amputate hand at wrist","description":"Disarticulation through wrist;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1391.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19085","name":"Bx breast 1st lesion mr imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including magnetic resonance guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63194","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33257","name":"Ablate atria lmtd add-on","description":"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75574","name":"Ct angio hrt w/3d image","description":"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87391","name":"Hiv-2 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23552","name":"Optx acrclv dslc aq/chrn grf","description":"Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23031","name":"I&d shoulder infected bursa","description":"Incision and drainage, shoulder area; infected bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83945","name":"Assay of oxalate","description":"Oxalate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","name":"Anes nrv msc upr a&e tnplsty","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68328","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23040","name":"Arthrt gh jt expl/drg/rmv fb","description":"Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41113","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; posterior one-third","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4928","name":"Surgical mask","description":"Surgical mask, per 20","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93798","name":"Phys/qhp op car rhab w/ecg","description":"Physician or other qualified health care professional services for outpatient cardiac rehabilitation; with continuous ecg monitoring (per session)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01520","name":"Anes px veins lower leg nos","description":"Anesthesia for procedures on veins of lower leg; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35311","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; subclavian, innominate, by thoracic incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69602","name":"Rev mstdc rslt mod rad mstdc","description":"Revision mastoidectomy; resulting in modified radical mastoidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0324","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52354","name":"Cystouretero w/biopsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01520","name":"Anes px veins lower leg nos","description":"Anesthesia for procedures on veins of lower leg; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82105","name":"Alpha-fetoprotein serum","description":"Alpha-fetoprotein (afp); serum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21249","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":925.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92273","name":"Full field erg w/i&r","description":"Electroretinography (erg), with interpretation and report; full field (ie, fferg, flash erg, ganzfeld erg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35286","name":"Rpr blvsl grf oth/th vn lxtr","description":"Repair blood vessel with graft other than vein; lower extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33778","name":"Rpr tga aortic pulm art rcns","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2045.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50432","name":"Plmt nephrostomy catheter","description":"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9505","name":"Tl201 thallium","description":"Thallium tl-201 thallous chloride, diagnostic, per millicurie","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25365","name":"Revise radius & ulna","description":"Osteotomy; radius and ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78496","name":"Heart first pass add-on","description":"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11462","name":"Exc skn hdrdnt ing smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or intermediate repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","name":"Anes male gent compl amp pns","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); complete amputation of penis","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3204","name":"Hightop w/ supp/pronator inf","description":"Orthopedic shoe, hightop with supinator or pronator, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20970","name":"Bone/skin graft iliac crest","description":"Free osteocutaneous flap with microvascular anastomosis; iliac crest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2428.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36822","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01470","name":"Anes px nrv msc lw l/a/f nos","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6306.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35485","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8879.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15772","name":"Grfg autol fat lipo ea addl","description":"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; each additional 50 cc injectate, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32604","name":"Thoracoscopy wbx sac","description":"Thoracoscopy, diagnostic (separate procedure); pericardial sac, with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6254.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99411","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95973","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95071","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39503","name":"Repair of diaphragm hernia","description":"Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82747","name":"Assay of folic acid rbc","description":"Folic acid; rbc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17108","name":"Dstr cut vsc prlf les>50sqcm","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); over 50.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85244","name":"Clot factor viii reltd antgn","description":"Clotting; factor viii related antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27734","name":"Repair lower leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia and fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77078","name":"Ct bone density axial","description":"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23106","name":"Arthrotomy strnclav joint","description":"Arthrotomy; sternoclavicular joint, with synovectomy, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17350.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44025","name":"Incision of large bowel","description":"Colotomy, for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":813.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21366","name":"Opn tx complx malar w/grft","description":"Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with bone grafting (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37193","name":"Rem endovas vena cava filter","description":"Retrieval (removal) of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53515","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35131","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, iliac artery (common, hypogastric, external)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47542","name":"Dilate biliary duct/ampulla","description":"Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each duct (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77059","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72133","name":"Ct lumbar spine w/o & w/dye","description":"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87803","name":"Clostridium toxin a w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; clostridium difficile toxin a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11004","name":"Dbrdmt skin xtrnl gent&per","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26750","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36145","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69718","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63050","name":"Cervical laminoplsty 2/> seg","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4489.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2365.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43253","name":"Egd us transmural injxn/mark","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (eg, anesthetic, neurolytic agent) or fiducial marker(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duoden","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60605","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; with excision of carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1464.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0244","name":"Toilet seat raised","description":"Raised toilet seat","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93555","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1487.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99460","name":"Init nb em per day hosp","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":39.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97802","name":"Medical nutrition indiv in","description":"Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9484","name":"Remote e/m new pt 45mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76816","name":"Ob us follow-up per fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetu","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29900","name":"Mcp joint arthroscopy dx","description":"Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58110","name":"Bx done w/colposcopy add-on","description":"Endometrial sampling (biopsy) performed in conjunction with colposcopy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87551","name":"Mycobacteria dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23180","name":"Prtl excision bone clavicle","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), clavicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82157","name":"Assay of androstenedione","description":"Androstenedione","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43215","name":"Esophagoscopy flex remove fb","description":"Esophagoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36810","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (scribner type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1751.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8778.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87809","name":"Adenovirus assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1148.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80422","name":"Glucagon tolerance panel","description":"Glucagon tolerance panel; for insulinoma this panel must include the following: glucose (82947 x 3) insulin (83525 x 3)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95921","name":"Autonomic nrv parasym inervj","description":"Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded r-r interval, valsalva ratio, and 30:15 ratio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93282","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72146","name":"Mri chest spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54380","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25272","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, single, each tendon or muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36148","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95723","name":"Eeg phy/qhp>60<84 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 60 hours, up to 84 hours of eeg recording, without video","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77032","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4298.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57307","name":"Fistula repair & colostomy","description":"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84590","name":"Assay of vitamin a","description":"Vitamin a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25449","name":"Revj arthrp wrist joint","description":"Revision of arthroplasty, including removal of implant, wrist joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54120","name":"Partial removal of penis","description":"Amputation of penis; partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","name":"Anes cls px upr tib fib&/pat","description":"Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11443","name":"Exc face-mm b9+marg 2.1-3 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30462","name":"Revision of nose","description":"Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip, septum, osteotomies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2862.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6198","name":"Alginate dressing > 48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33263","name":"Rmvl & rplcmt dfb gen 2 lead","description":"Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; dual lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88367","name":"Insitu hybridization auto","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83065","name":"Hemoglobin thermolabile","description":"Hemoglobin; thermolabile","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4875.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57500","name":"Biopsy of cervix","description":"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26746","name":"Treat finger fracture each","description":"Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, includes internal fixation, when performed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32665","name":"Thoracoscop w/esoph musc exc","description":"Thoracoscopy, surgical; with esophagomyotomy (heller type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50690","name":"Injection for ureter x-ray","description":"Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44140","name":"Partial removal of colon","description":"Colectomy, partial; with anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","name":"Anes open total ankle rplcmt","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50961","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1850.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78830","name":"Rp loclzj tum spect w/ct 1","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","name":"Anes ivntl rad icr icar/aort","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or aortic","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81234","name":"Dmpk gene detc abnor allele","description":"Dmpk (dm1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21401","name":"Closed tx orbit w/manipulj","description":"Closed treatment of fracture of orbit, except blowout; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32650","name":"Thoracoscopy w/pleurodesis","description":"Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33229","name":"Remv&replc pm gen mult leads","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; multiple lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69720","name":"Release facial nerve","description":"Decompression facial nerve, intratemporal; lateral to geniculate ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77051","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28108","name":"Removal of toe lesions","description":"Excision or curettage of bone cyst or benign tumor, phalanges of foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29825","name":"Sho arthrs srg lss&rescj ads","description":"Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78268","name":"Urea breath test c-14 alys","description":"Urea breath test, c-14 (isotopic); analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50592","name":"Perc rf ablate renal tumor","description":"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0426","name":"Inpt/ed teleconsult50","description":"Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0761","name":"Nontherm electromgntc device","description":"Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35256","name":"Repair blvsl vn grf lxtr","description":"Repair blood vessel with vein graft; lower extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69905","name":"Remove inner ear","description":"Labyrinthectomy; transcanal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61626","name":"Tcat perm occls/embol noncns","description":"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention, percutaneous,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91010","name":"Esophagus motility study","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98940","name":"Chiropract manj 1-2 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 1-2 regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12007","name":"Rpr s/n/ax/gen/trnk >30.0 cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31257","name":"Nsl/sins ndsc tot w/sphendt","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36216","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92591","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21725","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; with cast application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21610","name":"Costotransversectomy","description":"Costotransversectomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75978","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20939","name":"Bone marrow aspir bone grfg","description":"Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78472","name":"Gated heart planar single","description":"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33255","name":"Ablate atria w/o bypass ext","description":"Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43645","name":"Lap gastr bypass incl smll i","description":"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1550.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97012","name":"Mechanical traction therapy","description":"Application of a modality to 1 or more areas; traction, mechanical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15825","name":"Rhytdct nck pltysml tghtg","description":"Rhytidectomy; neck with platysmal tightening (platysmal flap, p-flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84578","name":"Test urine urobilinogen","description":"Urobilinogen, urine; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87492","name":"Chlmyd trach dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80307","name":"Drug test prsmv chem anlyzr","description":"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay [eg, eia, elisa, emit, fpia, ia, kims, ria]), chromatography (eg, gc, hplc), and mass spectrometry either with or without chromatography, (eg, dart","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85421","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":274.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1634.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22590","name":"Arthrd pst tq craniocervical","description":"Arthrodesis, posterior technique, craniocervical (occiput-c2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28288","name":"Partial removal of foot bone","description":"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86684","name":"Hemophilus influenza antibdy","description":"Antibody; haemophilus influenza","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61313","name":"Crnec/crnot sttl icere","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1811.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3557.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72127","name":"Ct neck spine w/o & w/dye","description":"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96165","name":"Hlth bhv ivntj grp ea addl","description":"Health behavior intervention, group (2 or more patients), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25491","name":"Prophylactic tx ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57288","name":"Repair bladder defect","description":"Sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2005","name":"Post-d/c h vst new pt 75 m","description":"Extensive (75 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93312","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61563","name":"Excision of skull tumor","description":"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29882","name":"Arthrs kne srg mnisc rpr m/l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial or lateral)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2738.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27066","name":"Remove hip bone les deep","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; deep (subfascial), includes autograft, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87511","name":"Gardner vag dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87561","name":"M.avium-intra dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97113","name":"Aquatic therapy/exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64612","name":"Destroy nerve face muscle","description":"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4108.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33530","name":"Coronary artery bypass/reop","description":"Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53215","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; male","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3142.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73222","name":"Mri joint upr extrem w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4267","name":"Male condom","description":"Contraceptive supply, condom, male, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities: person-centered assessment, performed to better understand the indivi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3250","name":"Custom mold shoe remov prost","description":"Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26440","name":"Release palm/finger tendon","description":"Tenolysis, flexor tendon; palm or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69000","name":"Drg xtrnl ear absc/hem smpl","description":"Drainage external ear, abscess or hematoma; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21045","name":"Extensive jaw surgery","description":"Excision of malignant tumor of mandible; radical resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99233","name":"Sbsq hosp ip/obs high 50","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes m","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86617","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease) confirmatory test (eg, western blot or immunoblot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32200","name":"Drain open lung lesion","description":"Pneumonostomy, with open drainage of abscess or cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":904.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50070","name":"Nl comp cgen kdn abnormality","description":"Nephrolithotomy; complicated by congenital kidney abnormality","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","name":"Anes px hrt w/pump age 1yr+","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":557.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64834","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; hand or foot, common sensory nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61601","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2158.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93923","name":"Upr/lxtr art stdy 3+ lvls","description":"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional doppler wave","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2847.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87560","name":"M.avium-intra dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21632","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1044.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95803","name":"Actigraphy testing","description":"Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0115","name":"Post-coital mucous exam","description":"Post-coital direct, qualitative examinations of vaginal or cervical mucous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92980","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20956","name":"Iliac bone graft microvasc","description":"Bone graft with microvascular anastomosis; iliac crest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2246.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17283","name":"Dstr mal ls f/e/e/n/l/m2.1-3","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33990","name":"Insj perq vad l hrt arterial","description":"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, arterial access only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78453","name":"Ht muscle image planar sing","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44388","name":"Colonoscopy thru stoma spx","description":"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","53"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":38.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86609","name":"Bacterium antibody","description":"Antibody; bacterium, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4913.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15842","name":"Nerve palsy microsurg graft","description":"Graft for facial nerve paralysis; free muscle flap by microsurgical technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99473","name":"Self-meas bp pt educaj/train","description":"Self-measured blood pressure using a device validated for clinical accuracy; patient education/training and device calibration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69145","name":"Remove ear canal lesion(s)","description":"Excision soft tissue lesion, external auditory canal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48552","name":"Prep donor pancreas/venous","description":"Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82045","name":"Albumin ischemia modified","description":"Albumin; ischemia modified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99091","name":"Collj & interpj data ea 30 d","description":"Collection and interpretation of physiologic data (eg, ecg, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) r","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84446","name":"Assay of vitamin e","description":"Tocopherol alpha (vitamin e)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80410","name":"Calcitonin stimul panel","description":"Calcitonin stimulation panel (eg, calcium, pentagastrin) this panel must include the following: calcitonin (82308 x 3)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88302","name":"Tissue exam by pathologist","description":"Level ii - surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incident","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93005","name":"Electrocardiogram tracing","description":"Electrocardiogram, routine ecg with at least 12 leads; tracing only, without interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67250","name":"Reinforce eye wall","description":"Scleral reinforcement (separate procedure); without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81188","name":"Cstb gene detc abnor allele","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29740","name":"Wedging of cast","description":"Wedging of cast (except clubfoot casts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27185","name":"Revision of femur epiphysis","description":"Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97606","name":"Neg prs wnd ther dme>50 sqcm","description":"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (dme), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":657.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86834","name":"Hla class i semiquant panel","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); semi-quantitative panel (eg, titer), hla class i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36835","name":"Insertion thomas shunt","description":"Insertion of thomas shunt (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2453.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4657.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":0.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35092","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57308","name":"Fistula repair transperine","description":"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36570","name":"Insert picvad cath","description":"Insertion of peripherally inserted central venous access device, with subcutaneous port; younger than 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1220.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9040","name":"Rbc leukoreduced irradiated","description":"Red blood cells, leukocytes reduced, irradiated, each unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93890","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29856","name":"Tibial arthroscopy/surgery","description":"Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27828","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of both tibia and fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66988","name":"Xcapsl ctrc rmvl w/ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic cyclophotocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93721","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","name":"Anes art sho&ax ax-brch arsm","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96574","name":"Dbrdmt prmlg les w/pdt","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33523","name":"Cabg art-vein six or more","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7266","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22859","name":"Insj biomechanical device","description":"Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1248.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37609","name":"Ligation/bx temporal artery","description":"Ligation or biopsy, temporal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9609.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","name":"Anes px vn lwr leg ven thrmb","description":"Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51720","name":"Treatment of bladder lesion","description":"Bladder instillation of anticarcinogenic agent (including retention time)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42550","name":"Injection for salivary x-ray","description":"Injection procedure for sialography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74283","name":"Ther nma rdctj intus/obstrcj","description":"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83890","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93270","name":"Remote 30 day ecg rev/report","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; recording (includes connection, recording, and disconnection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93457","name":"R hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7236.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87081","name":"Culture screen only","description":"Culture, presumptive, pathogenic organisms, screening only;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42200","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, soft and/or hard palate only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26260","name":"Resect prox finger tumor","description":"Radical resection of tumor, proximal or middle phalanx of finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49407","name":"Image cath fluid trns/vgnl","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43231","name":"Esophagoscop ultrasound exam","description":"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":591.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94720","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93314","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23145","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1289.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6201","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"RC","billing_code_type_version":"2026","billing_code":"UNK","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]},{"negotiated_type":"negotiated","negotiated_rate":66.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]},{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]},{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]},{"negotiated_type":"negotiated","negotiated_rate":31.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]},{"negotiated_type":"negotiated","negotiated_rate":11.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]},{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]},{"negotiated_type":"negotiated","negotiated_rate":42.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]},{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]},{"negotiated_type":"negotiated","negotiated_rate":38.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43810","name":"Gastroduodenostomy","description":"Gastroduodenostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54161","name":"Circum 28 days or older","description":"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11041","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24920","name":"Amputation of upper arm","description":"Amputation, arm through humerus; open, circular (guillotine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47543","name":"Endoluminal bx biliary tree","description":"Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, single or multiple (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49002","name":"Reopening of abdomen","description":"Reopening of recent laparotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34844","name":"Endovasc visc aorta 4 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1632.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","name":"Anes opn/arthr px sho jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44137","name":"Remove intestinal allograft","description":"Removal of transplanted intestinal allograft, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20950","name":"Mntr intrstitial fluid press","description":"Monitoring of interstitial fluid pressure (includes insertion of device, eg, wick catheter technique, needle manometer technique) in detection of muscle compartment syndrome","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97598","name":"Dbrdmt opn wnd addl 20cm/<","description":"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when perform","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93556","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1874","name":"Stent, coated/cov w/del sys","description":"Stent, coated/covered, with delivery system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3310.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49561","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39531","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21016","name":"Resect face/scalp tum 2 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; 2 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67882","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33710","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass; with repair of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1501.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34847","name":"Visc & infraren abd 3 prosth","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2158.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85460","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; differential lysis (kleihauer-betke)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1976.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31632","name":"Bronchoscopy/lung bx addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93286","name":"Peri-px eval pm/ldls pm ip","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead pacemaker system, or leadless pacemaker ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22515","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; each additional thoracic or lumbar vertebra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3011.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94370","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","name":"Anes px heart w/pmp crc arst","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83904","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58152","name":"Total hysterectomy","description":"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, marshall-marchetti-krantz, burch)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"Esrd serv 4 visits p mo <2yr","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care pro","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2910.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0071","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37204","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92020","name":"Gonioscopy","description":"Gonioscopy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21365","name":"Opn tx complx malar fx","description":"Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with internal fixation and multiple surgical approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21048","name":"Remove maxilla cyst complex","description":"Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42802","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54050","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74248","name":"X-ray sm int f-thru std","description":"Radiologic small intestine follow-through study, including multiple serial images (list separately in addition to code for primary procedure for upper gi radiologic examination)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44111","name":"Excision of bowel lesion(s)","description":"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92950","name":"Heart/lung resuscitation cpr","description":"Cardiopulmonary resuscitation (eg, in cardiac arrest)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86304","name":"Immunoassay tumor ca 125","description":"Immunoassay for tumor antigen, quantitative; ca 125","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48154","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2441.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61550","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; single cranial suture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1075.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97039","name":"Unlisted modality","description":"Unlisted modality (specify type and time if constant attendance)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50561","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29800","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61791","name":"Treat trigeminal tract","description":"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64461","name":"Pvb thoracic single inj site","description":"Paravertebral block (pvb) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2026.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77777","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87427","name":"Shiga-like toxin ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; shiga-like toxin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80190","name":"Assay of procainamide","description":"Procainamide;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87103","name":"Blood fungus culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","name":"Anes integ sys conv arrhyt","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15260","name":"Fth/gft fr n/e/e/l 20 sqcm/<","description":"Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24565","name":"Cltx hum epcndylr fx w/mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28715","name":"Arthrodesis triple","description":"Arthrodesis; triple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2005.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29845","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1760.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45379","name":"Colonoscopy w/fb removal","description":"Colonoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","name":"Anes c hyst flwg neuraxial","description":"Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87185","name":"Sc std enzyme detcj per nzm","description":"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93631","name":"Ntraop epicar&endcar pac&map","description":"Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62311","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34846","name":"Visc & infraren abd 2 prosth","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1920.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46753","name":"Reconstruction of anus","description":"Graft (thiersch operation) for rectal incontinence and/or prolapse","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61615","name":"Resect/excise lesion skull","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or c1-c3 vertebral bodies; extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2550.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30120","name":"Revision of nose","description":"Excision or surgical planing of skin of nose for rhinophyma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21345","name":"Closed tx nose/jaw fx","description":"Closed treatment of nasomaxillary complex fracture (lefort ii type), with interdental wire fixation or fixation of denture or splint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27759","name":"Treatment of tibia fracture","description":"Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without interlocking screws and/or cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4467.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0240","name":"Bath/shower chair","description":"Bath/shower chair, with or without wheels, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14302","name":"Tis trnfr addl 30 sq cm","description":"Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93620","name":"Comp ep evl r at ven pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43238","name":"Egd us fine needle bx/aspir","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22216","name":"Incis addl spine segment","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":31.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46937","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54800","name":"Biopsy of epididymis","description":"Biopsy of epididymis, needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58180","name":"Partial hysterectomy","description":"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35558","name":"Art byp grft fem-femoral","description":"Bypass graft, with vein; femoral-femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26756","name":"Pin finger fracture each","description":"Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27645","name":"Resect tibia tumor","description":"Radical resection of tumor; tibia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82108","name":"Assay of aluminum","description":"Aluminum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15421","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27080","name":"Removal of tail bone","description":"Coccygectomy, primary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95873","name":"Guide nerv destr elec stim","description":"Electrical stimulation for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28308","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44363","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93981","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45136","name":"Excise ileoanal reservior","description":"Excision of ileoanal reservoir with ileostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1396.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3223.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31615","name":"Trcheobrnchsc est trachs inc","description":"Tracheobronchoscopy through established tracheostomy incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3806.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51797","name":"Intraabdominal pressure test","description":"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5980.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28455","name":"Tx tarsal b1 fx w/mnpj each","description":"Treatment of tarsal bone fracture (except talus and calcaneus); with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86631","name":"Chlamydia antibody","description":"Antibody; chlamydia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54406","name":"Remove muti-comp penis pros","description":"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33981","name":"Replace vad pump ext","description":"Replacement of extracorporeal ventricular assist device, single or biventricular, pump(s), single or each pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45393","name":"Colonoscopy w/decompression","description":"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35701","name":"Expl n/flwd surg neck art","description":"Exploration not followed by surgical repair, artery; neck (eg, carotid, subclavian)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97750","name":"Physical performance test","description":"Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92523","name":"Speech sound lang comprehen","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31297","name":"Nsl/sins ndsc surg sphn sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); sphenoid sinus ostium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1396.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33206","name":"Insert heart pm atrial","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88184","name":"Flowcytometry/ tc 1 marker","description":"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33884","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86316","name":"Immunoassay tumor other","description":"Immunoassay for tumor antigen, other antigen, quantitative (eg, ca 50, 72-4, 549), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15401","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42410","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0210U","name":"Syphilis tst antb ia quan 5","description":"Syphilis tst antb ia quan 5","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21030","name":"Excise max/zygoma b9 tumor","description":"Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54332","name":"Revise penis/urethra","description":"1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19000","name":"Puncture aspir cyst breast","description":"Puncture aspiration of cyst of breast;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23480","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4045.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21556","name":"Exc neck tum deep < 5 cm","description":"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44615","name":"Intestinal stricturoplasty","description":"Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for intestinal obstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43226","name":"Esoph endoscopy dilation","description":"Esophagoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) over guide wire","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33951","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67915","name":"Repair eyelid defect","description":"Repair of ectropion; thermocauterization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35111","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, splenic artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25690","name":"Cltx lunate dislc w/mnpj","description":"Closed treatment of lunate dislocation, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8999","name":"Resuscitation bag","description":"Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11387.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93314","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66030","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); medication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93041","name":"Rhythm ecg tracing","description":"Rhythm ecg, 1-3 leads; tracing only without interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1481.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24363","name":"Replace elbow joint","description":"Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24300","name":"Mnpj elbow under anes","description":"Manipulation, elbow, under anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92990","name":"Revision of pulmonary valve","description":"Percutaneous balloon valvuloplasty; pulmonary valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20612","name":"Aspirate/inj ganglion cyst","description":"Aspiration and/or injection of ganglion cyst(s) any location","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3524.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KC","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21249","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26250","name":"Extensive hand surgery","description":"Radical resection of tumor, metacarpal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33916","name":"Surgery of great vessel","description":"Pulmonary endarterectomy, with or without embolectomy, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3695.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28760","name":"Fusion of big toe joint","description":"Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great toe, interphalangeal joint (eg, jones type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4775.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30150","name":"Rhinectomy partial","description":"Rhinectomy; partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26357","name":"Repair finger/hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); secondary, without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41821","name":"Excision of gum flap","description":"Operculectomy, excision pericoronal tissues","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3450.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4725.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1441.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27700","name":"Revision of ankle joint","description":"Arthroplasty, ankle;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23125","name":"Claviculectomy total","description":"Claviculectomy; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90901","name":"Biofeedback train any meth","description":"Biofeedback training by any modality","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78804","name":"Rp loclzj tum whbdy 2+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96139","name":"Psycl/nrpsyc tst tech ea","description":"Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99422","name":"Ol dig e/m svc 11-20 min","description":"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32660","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83498","name":"Asy hydroxyprogesterone 17-d","description":"Hydroxyprogesterone, 17-d","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27076","name":"Resect hip tum incl acetabul","description":"Radical resection of tumor; ilium, including acetabulum, both pubic rami, or ischium and acetabulum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50830","name":"Revise urine flow","description":"Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1457.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82941","name":"Assay of gastrin","description":"Gastrin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25310","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3684.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90952","name":"Esrd serv 2-3 vsts p mo <2yr","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15151","name":"Tis cltr skn agrft t/a/l add","description":"Tissue cultured skin autograft, trunk, arms, legs; additional 1 sq cm to 75 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25100","name":"Biopsy of wrist joint","description":"Arthrotomy, wrist joint; with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76936","name":"Echo guide for artery repair","description":"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93613","name":"Intracardiac ephys 3d mapg","description":"Intracardiac electrophysiologic 3-dimensional mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0252","name":"Pet imaging initial dx","description":"Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99415","name":"Prolng clin staff svc 1st hr","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (list separately in addition to code for out","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37735","name":"Lig&div&compl strpg saph vn","description":"Ligation and division and complete stripping of long or short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of deep fascia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25150","name":"Partial removal of ulna","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88720","name":"Bilirubin total transcut","description":"Bilirubin, total, transcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76816","name":"Ob us follow-up per fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetu","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95251","name":"Cont gluc mntr analysis i&r","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47562","name":"Laparoscopic cholecystectomy","description":"Laparoscopy, surgical; cholecystectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92371","name":"Rpr&refit spct prsth aphakia","description":"Repair and refitting spectacles; spectacle prosthesis for aphakia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":109.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23570","name":"Cltx scapular fx w/o mnpj","description":"Closed treatment of scapular fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96373","name":"Ther/proph/diag inj ia","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intra-arterial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63091","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63277","name":"Bx/exc xdrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0319","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97016","name":"Vasopneumatic device therapy","description":"Application of a modality to 1 or more areas; vasopneumatic devices","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51900","name":"Repair bladder/vagina lesion","description":"Closure of vesicovaginal fistula, abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1571.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36822","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76513","name":"Oph us dx ant sgm us uni/bi","description":"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) b-scan or high resolution biomicroscopy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21188","name":"Reconstruction of midface","description":"Reconstruction midface, osteotomies (other than lefort type) and bone grafts (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1294.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93702","name":"Bis xtracell fluid analysis","description":"Bioimpedance spectroscopy (bis), extracellular fluid analysis for lymphedema assessment(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50392","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L2860","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86000","name":"Agglutinins febrile antigen","description":"Agglutinins, febrile (eg, brucella, francisella, murine typhus, q fever, rocky mountain spotted fever, scrub typhus), each antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73721","name":"Mri jnt of lwr extre w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62161","name":"Dissect brain w/scope","description":"Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1376.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54352","name":"Revj prior hypspad repair","description":"Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of local skin as grafts and island flaps and skin brought in as flaps or grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1146.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41017","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59136","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10006","name":"Fna bx w/us gdn ea addl","description":"Fine needle aspiration biopsy, including ultrasound guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96900","name":"Actinotherapy uv light","description":"Actinotherapy (ultraviolet light)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82608","name":"B-12 binding capacity","description":"Cyanocobalamin (vitamin b-12); unsaturated binding capacity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88307","name":"Tissue exam by pathologist","description":"Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11621","name":"Exc s/n/h/f/g mal+mrg 0.6-1","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22336.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5877.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","name":"Anes opn lwr l/a/f rad rescj","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26235","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); proximal or middle phalanx of finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1481.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73723","name":"Mri joint lwr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83912","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1876","name":"Stent, non-coa/non-cov w/del","description":"Stent, non-coated/non-covered, with delivery system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1732.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86332","name":"Immune complex assay","description":"Immune complex assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","name":"Anes opn upr 2/3 fem rad res","description":"Anesthesia for open procedures involving upper two-thirds of femur; radical resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29582","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97150","name":"Group therapeutic procedures","description":"Therapeutic procedure(s), group (2 or more individuals)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86384","name":"Nitroblue tetrazolium dye","description":"Nitroblue tetrazolium dye test (ntd)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29058","name":"Appl cast plaster velpeau","description":"Application, cast; plaster velpeau","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29025","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93640","name":"Ep eval 1/2chmbr pacg cvdfb","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57284","name":"Repair paravag defect open","description":"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63661","name":"Remove spine eltrd perq aray","description":"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46083","name":"Inc thrombosed hroid xtrnl","description":"Incision of thrombosed hemorrhoid, external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64809","name":"Sympathectomy thoracolumbar","description":"Sympathectomy, thoracolumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21366","name":"Opn tx complx malar w/grft","description":"Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with bone grafting (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31256","name":"Exploration maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31620","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84252","name":"Assay of vitamin b-2","description":"Riboflavin (vitamin b-2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5877.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4153","name":"Ef hydrolyzed/amino acids","description":"Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78433","name":"Myocrd img pet 2rtracer ct","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33741","name":"Tas congenital car anomal","description":"Transcatheter atrial septostomy (tas) for congenital cardiac anomalies to create effective atrial flow, including all imaging guidance by the proceduralist, when performed, any method (eg, rashkind, sang-park, balloon, cutting balloon, blade)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4534.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6213","name":"Foam drg >16<=48 sq in w/bdr","description":"Foam 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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83030","name":"Hemoglobin f fetal chemical","description":"Hemoglobin; f (fetal), chemical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28360","name":"Reconstruct cleft foot","description":"Reconstruction, cleft foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20205","name":"Deep muscle biopsy","description":"Biopsy, muscle; deep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75774","name":"Artery x-ray each vessel","description":"Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88261","name":"Chromosome analysis 5","description":"Chromosome analysis; count 5 cells, 1 karyotype, with banding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0191","name":"Misoprostol, oral, 200 mcg","description":"Misoprostol, oral, 200 mcg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61682","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4018.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93526","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0427","name":"Inpt/ed teleconsult70","description":"Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51100","name":"Drain bladder by needle","description":"Aspiration of bladder; by needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":188.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43754","name":"Dx gastr intub w/asp spec","description":"Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95939","name":"C motor evoked upr&lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93543","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0445","name":"Oximeter non-invasive","description":"Oximeter device for measuring blood oxygen levels non-invasively","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93923","name":"Upr/lxtr art stdy 3+ lvls","description":"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional doppler wave","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32124","name":"Explore chest free adhesions","description":"Thoracotomy; with open intrapleural pneumonolysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83909","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0398","name":"Home sleep test/type 2 porta","description":"Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64680","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96401","name":"Chemo anti-neopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97018","name":"Paraffin bath therapy","description":"Application of a modality to 1 or more areas; paraffin bath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97761","name":"Prosthetic traing 1st enc","description":"Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47130","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total right lobectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2771.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32855","name":"Prepare donor lung single","description":"Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4034","name":"Enter feed supkit syr by day","description":"Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78464","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88309","name":"Tissue exam by pathologist","description":"Level vi - surgical pathology, gross and microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection extremity, disarticulation fetus, with dissection larynx, partial/total resect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1044.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17360","name":"Chemical exfoliation acne","description":"Chemical exfoliation for acne (eg, acne paste, acid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31770","name":"Repair/graft of bronchus","description":"Bronchoplasty; graft repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80406","name":"Acth stimulation panel","description":"Acth stimulation panel; for 3 beta-hydroxydehydrogenase deficiency this panel must include the following: cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53601","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99305","name":"1st nf care moderate mdm 35","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or ex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32607","name":"Thoracoscopy w/bx infiltrate","description":"Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93461","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, cath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86255","name":"Fluorescent antibody screen","description":"Fluorescent noninfectious agent antibody; screen, each antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50593","name":"Perc cryo ablate renal tum","description":"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3498.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24101","name":"Arthrt elbw jt expl bx rmvl","description":"Arthrotomy, elbow; with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38208","name":"Thaw preserved stem cells","description":"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing, per donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63172","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69604","name":"Revj mstdc rsltg tympanplsty","description":"Revision mastoidectomy; resulting in tympanoplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63088","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1918.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26820","name":"Thumb fusion with graft","description":"Fusion in opposition, thumb, with autogenous graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76886","name":"Us exam infant hips static","description":"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87275","name":"Influenza b ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza b virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82365","name":"Calculus spectroscopy","description":"Calculus; infrared spectroscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28485","name":"Optx metatarsal fx each","description":"Open treatment of metatarsal fracture, includes internal fixation, when performed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95870","name":"Ndl emg lmtd std musc 1 xtr","description":"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87271","name":"Cytomegalovirus dfa","description":"Infectious agent antigen detection by immunofluorescent technique; cytomegalovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33946","name":"Ecmo/ecls initiation venous","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-venous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3241.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73502","name":"X-ray exam hip uni 2-3 views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24545","name":"Optx hum fx wo ntrcndylr xtn","description":"Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; without intercondylar extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27450","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; with fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38760","name":"Remove groin lymph nodes","description":"Inguinofemoral lymphadenectomy, superficial, including cloquets node (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32664","name":"Thoracoscopy w/ th nrv exc","description":"Thoracoscopy, surgical; with thoracic sympathectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69915","name":"Incise inner ear nerve","description":"Vestibular nerve section, translabyrinthine approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1228.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93657","name":"Tx l/r atrial fib addl","description":"Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67316","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63265","name":"Excise intraspinl lesion crv","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1512.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95133","name":"Immntx 4 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 4 stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47300","name":"Surgery for liver lesion","description":"Marsupialization of cyst or abscess of liver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63042","name":"Laminotomy single lumbar","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1142.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70554","name":"Fmri brain by tech","description":"Magnetic resonance imaging, brain, functional mri; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12037","name":"Intmd rpr s/tr/ext >30.0 cm","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); over 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24650","name":"Cltx rdl head/nck fx wo mnpj","description":"Closed treatment of radial head or neck fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95832","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2466.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21260","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51065","name":"Remove ureter calculus","description":"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81188","name":"Cstb gene detc abnor allele","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441T","name":"Abltj perc lxtr/perph nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61580","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2058.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84300","name":"Assay of urine sodium","description":"Sodium; urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53200","name":"Biopsy of urethra","description":"Biopsy of urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5510","name":"Compression form shoe insert","description":"For diabetics only, direct formed, compression molded to patients foot without external heat source, multiple-density insert(s) prefabricated, per shoe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76125","name":"Cine/video x-rays add-on","description":"Cineradiography/videoradiography to complement routine examination (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22868","name":"Insj stablj dev w/dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2142.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33957","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","name":"Anes opn upr 2/3 fem rad res","description":"Anesthesia for open procedures involving upper two-thirds of femur; radical resection","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53210","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; female","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54115","name":"Treatment of penis lesion","description":"Removal foreign body from deep penile tissue (eg, plastic implant)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54205","name":"Njx px peyronie ds exps plaq","description":"Injection procedure for peyronie disease; with surgical exposure of plaque","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1539.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99416","name":"Prolng clin staff svc ea add","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (list separately in addition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63295","name":"Repair laminectomy defect","description":"Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37229","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5661.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31030","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) without removal of antrochoanal polyps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64569","name":"Revise/repl vagus n eltrd","description":"Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69805","name":"Explore inner ear","description":"Endolymphatic sac operation; without shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":620.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88164","name":"Cytopath tbs c/v manual","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); manual screening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27816","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64408","name":"Njx aa&/strd vagus nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; vagus nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97535","name":"Self care mngment training","description":"Self-care/home management training (eg, activities of daily living (adl) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23680","name":"Optx sho dislc neck fx fixj","description":"Open treatment of shoulder dislocation, with surgical or anatomical neck fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33321","name":"Repair major vessel","description":"Suture repair of aorta or great vessels; with shunt bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1027.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10061","name":"I&d abscess comp/multiple","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87540","name":"Legion pneumo dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95801","name":"Slp stdy unatnd w/anal","description":"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27248","name":"Treat thigh fracture","description":"Open treatment of greater trochanteric fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62117","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1801.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86778","name":"Toxoplasma antibody igm","description":"Antibody; toxoplasma, igm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10081","name":"I&d pilonidal cyst comp","description":"Incision and drainage of pilonidal cyst; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64788","name":"Remove skin nerve lesion","description":"Excision of neurofibroma or neurolemmoma; cutaneous nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61751","name":"Brain biopsy w/ct/mr guide","description":"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":97.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","QB","NU","QF","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59830","name":"Treat uterus infection","description":"Treatment of septic abortion, completed surgically","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42300","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59510","name":"Cesarean delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11106","name":"Incal bx skn single les","description":"Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49605","name":"Repair umbilical lesion","description":"Repair of large omphalocele or gastroschisis; with or without prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4188.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95992","name":"Canalith repositioning proc","description":"Canalith repositioning procedure(s) (eg, epley maneuver, semont maneuver), per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94777","name":"Ped home apnea mntr rvw i&r","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; review, interpretation and preparation of report only by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4649","name":"Surgical supplies","description":"Surgical supply; miscellaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88272","name":"Cytogenetics 3-5","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"Tympanometry & reflex thresh","description":"Tympanometry and reflex threshold measurements","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68360","name":"Revise eyelid lining","description":"Conjunctival flap; bridge or partial (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1972.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43281","name":"Lap paraesophag hern repair","description":"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69745","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6005","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19282","name":"Perq device breast ea imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including mammographic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33866","name":"Aortic hemiarch graft","description":"Aortic hemiarch graft including isolation and control of the arch vessels, beveled open distal aortic anastomosis extending under one or more of the arch vessels, and total circulatory arrest or isolated cerebral perfusion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27767","name":"Cltx post ankle fx","description":"Closed treatment of posterior malleolus fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":197.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31382","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); antero-latero-vertical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1584.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0342","name":"Laparoscopy islet cell trans","description":"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4879.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26596","name":"Excision constricting tissue","description":"Excision of constricting ring of finger, with multiple z-plasties","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95805","name":"Multiple sleep latency test","description":"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31560","name":"Laryngoscop w/arytenoidectom","description":"Laryngoscopy, direct, operative, with arytenoidectomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64643","name":"Chemodenerv 1 extrem 1-4 ea","description":"Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87254","name":"Virus inoculation shell via","description":"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27846","name":"Treat ankle dislocation","description":"Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; without repair or internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52353","name":"Cystouretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35081","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1525.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54900","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":796.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85246","name":"Clot factor viii vw antigen","description":"Clotting; factor viii, vw factor antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43220","name":"Esophagoscopy balloon <30mm","description":"Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22800","name":"Arthrd pst dfrm<6 vrt sgm","description":"Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1186.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87481","name":"Candida dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22534","name":"Arthrd lat xtrcvtry tq ea ad","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic or lumbar, each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90378","name":"Rsv mab im 50mg","description":"Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular use, 50 mg, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2075.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90662","name":"Iiv no prsv increased ag im","description":"Influenza virus vaccine (iiv), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86835","name":"Hla class ii semiquant panel","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); semi-quantitative panel (eg, titer), hla class ii","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61001","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90806","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21088","name":"Impres&prep facial prosth","description":"Impression and custom preparation; facial prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4778.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25170","name":"Resect radius/ulnar tumor","description":"Radical resection of tumor, radius or ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59622","name":"Attempted vbac after care","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21248","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92606","name":"Non-speech device service","description":"Therapeutic service(s) for the use of non-speech-generating device, including programming and modification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90880","name":"Hypnotherapy","description":"Hypnotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78122","name":"Whl bld volume determination","description":"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35483","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64553","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; cranial nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1638.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76376","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90853","name":"Group psychotherapy","description":"Group psychotherapy (other than of a multiple-family group)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82190","name":"Atomic absorption","description":"Atomic absorption spectroscopy, each analyte","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":33.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99050","name":"Medical services after hrs","description":"Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed (eg, holidays, saturday or sunday), in addition to basic service","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15757","name":"Free skin flap microvasc","description":"Free skin flap with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1445.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62256","name":"Remove brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; without replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"Immunization admin","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92132","name":"Cptrzd oph dx img ant sgm","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), anterior segment, with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26110","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; interphalangeal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4606","name":"Oxygen probe used w oximeter","description":"Oxygen probe for use with oximeter device, replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92285","name":"External ocular photography","description":"External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"Esrd serv 4 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28046","name":"Resect foot/toe tumor < 3 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53040","name":"Drainage of urethra abscess","description":"Drainage of deep periurethral abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28020","name":"Exploration of foot joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95149","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 5 single stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2443.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43284","name":"Laps esophgl sphnctr agmntj","description":"Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0084","name":"Care man h v ext pt 60 m","description":"Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1063.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99605","name":"Mtms by pharm np 15 min","description":"Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; initial 15 minutes, new patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59857","name":"Induced ab 1+vag supp hyst","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed medical evacuation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33608","name":"Repair anomaly w/conduit","description":"Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal defect by construction or replacement of conduit from right or left ventricle to pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31571","name":"Laryngoscop w/vc inj + scope","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2549.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99471","name":"Ped critical care initial","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28100","name":"Removal of ankle/heel lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64573","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6228","name":"Gauze <= 16 sq in water/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35361","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19316","name":"Mastopexy","description":"Mastopexy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88267","name":"Chromosome analys placenta","description":"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26991","name":"Drainage of pelvis bursa","description":"Incision and drainage, pelvis or hip joint area; infected bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11982.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36225","name":"Place cath subclavian art","description":"Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9984","name":"Remote e/m est. pt 15mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: an expanded problem focused history;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41825","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27179","name":"Revise head/neck of femur","description":"Open treatment of slipped femoral epiphysis; osteoplasty of femoral neck (heyman type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28755","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65265","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50010","name":"Renal exploration","description":"Renal exploration, not necessitating other specific procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8220.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49657","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15733","name":"Musc myoq/fscq flp h&n pedcl","description":"Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10368.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82360","name":"Calculus assay quant","description":"Calculus; quantitative analysis, chemical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11755","name":"Biopsy nail unit","description":"Biopsy of nail unit (eg, plate, bed, matrix, hyponychium, proximal and lateral nail folds) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90887","name":"Interpj/explnaj rslt psyc xm","description":"Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data to family or other responsible persons, or advising them how to assist patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0118","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27700","name":"Revision of ankle joint","description":"Arthroplasty, ankle;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72292","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58825","name":"Transposition ovary(s)","description":"Transposition, ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88130","name":"Sex chromatin identification","description":"Sex chromatin identification; barr bodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82671","name":"Assay of estrogens","description":"Estrogens; fractionated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27594","name":"Amputation follow-up surgery","description":"Amputation, thigh, through femur, any level; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85175","name":"Blood clot lysis time","description":"Clot lysis time, whole blood dilution","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24620","name":"Cltx monteggia fx dislc elbw","description":"Closed treatment of monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"Venipuncture cutdown < 1 yr","description":"Venipuncture, cutdown; younger than age 1 year","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45330","name":"Diagnostic sigmoidoscopy","description":"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92201","name":"Opscpy extnd rta draw uni/bi","description":"Ophthalmoscopy, extended; with retinal drawing and scleral depression of peripheral retinal disease (eg, for retinal tear, retinal detachment, retinal tumor) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27393","name":"Lengthening of thigh tendon","description":"Lengthening of hamstring tendon; single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99375","name":"Home health care supervision","description":"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, alzheimers facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23106","name":"Arthrotomy strnclav joint","description":"Arthrotomy; sternoclavicular joint, with synovectomy, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25360","name":"Revision of ulna","description":"Osteotomy; ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1037.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1832.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4714","name":"Treated water per gallon","description":"Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70542","name":"Mri orbit/face/neck w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4607.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15273","name":"Skin sub grft t/arm/lg child","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44365","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96425","name":"Chemotherapy infusion method","description":"Chemotherapy administration, intra-arterial; infusion technique, initiation of prolonged infusion (more than 8 hours), requiring the use of a portable or implantable pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33851","name":"Exc coa rpr l subcl art/prst","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; repair using either left subclavian artery or prosthetic material as gusset for enlargement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44158","name":"Colectomy w/neo-rectum pouch","description":"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, creation of ileal reservoir (s or j), includes loop ileostomy, and rectal mucosectomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1882.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4270","name":"Disposable endoscope sheath","description":"Disposable endoscope sheath, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93986","name":"Dup-scan hemo compl uni std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92558","name":"Evoked auditory test qual","description":"Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68326","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":694.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31775","name":"Reconstruct bronchus","description":"Bronchoplasty; excision stenosis and anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1972.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24579","name":"Optx humrl cndylr fracture","description":"Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21120","name":"Genioplasty augmentation","description":"Genioplasty; augmentation (autograft, allograft, prosthetic material)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27552","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35001","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, carotid, subclavian artery, by neck incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35876","name":"Removal of clot in graft","description":"Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); with revision of arterial or venous graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93316","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45397","name":"Lap remove rectum w/pouch","description":"Laparoscopy, surgical; proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, j-pouch), with diverting enterostomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1699.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1462.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4082","name":"Enteral ng tubing w/o stylet","description":"Nasogastric tubing without stylet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82696","name":"Assay of etiocholanolone","description":"Etiocholanolone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97010","name":"Hot or cold packs therapy","description":"Application of a modality to 1 or more areas; hot or cold packs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93976","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5266","name":"Battery for hearing device","description":"Battery for use in hearing device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78473","name":"Gated heart multiple","description":"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00860","name":"Anes xtrprtl px lwr abd nos","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3960.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33017","name":"Prcrd drg 6yr+ w/o cgen car","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; 6 years and older without congenital cardiac anomaly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43112","name":"Esphg tot w/thrcm","description":"Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (ie, mckeown esophagectomy or tri-incisional esophagectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2907.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92998","name":"Pul art balloon repr percut","description":"Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58571","name":"Tlh w/t/o 250 g or less","description":"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93017","name":"Cv stress test tracing only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2410.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93224","name":"Xtrnl ecg rec up to 48 hrs","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6256","name":"Absorpt drg > 48 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31560","name":"Laryngoscop w/arytenoidectom","description":"Laryngoscopy, direct, operative, with arytenoidectomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27769","name":"Optx post ankle fx","description":"Open treatment of posterior malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":157.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3890","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","name":"Anes px ear w/bx nos","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9051.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76828","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62291","name":"Njx px discography crv/thrc","description":"Injection procedure for discography, each level; cervical or thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5429.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","name":"Anes opn upr 2/3 fem rad res","description":"Anesthesia for open procedures involving upper two-thirds of femur; radical resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59320","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; vaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85415","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen activator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28750","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; metatarsophalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33251","name":"Ablate heart dysrhythm focus","description":"Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, wolff-parkinson-white, atrioventricular node re-entry), tract(s) and/or focus (foci); with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1412.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50280","name":"Exc/unroofing cyst kidney","description":"Excision or unroofing of cyst(s) of kidney","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":783.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","name":"Anes opn/arthrs px elbw nos","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60210","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43249","name":"Esoph egd dilation <30 mm","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24102","name":"Arthrt elbow w/synovectomy","description":"Arthrotomy, elbow; with synovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87486","name":"Chlmyd pneum dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21025","name":"Excision of bone lower jaw","description":"Excision of bone (eg, for osteomyelitis or bone abscess); mandible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99495","name":"Transj care mgmt mod f2f 14d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge at least moderate level of medical decision making during the service period face-to-face visit, wit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75960","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42844","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with local flap (eg, tongue, buccal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77003","name":"Fluoroguide for spine inject","description":"Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88162","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62282","name":"Treat spinal canal lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1423.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26262","name":"Resect distal finger tumor","description":"Radical resection of tumor, distal phalanx of finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","name":"Anes opn/arthrs px elbw nos","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54535","name":"Extensive testis surgery","description":"Orchiectomy, radical, for tumor; with abdominal exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36513","name":"Apheresis platelets","description":"Therapeutic apheresis; for platelets","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27100","name":"Transfer of abdominal muscle","description":"Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23400","name":"Fixation of shoulder blade","description":"Scapulopexy (eg, sprengels deformity or for paralysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62281","name":"Treat spinal cord lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4224","name":"Parenteral administration ki","description":"Parenteral nutrition administration kit, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","name":"Anes px art knee&pop teaec","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82656","name":"El-1 fecal qual/semiq","description":"Elastase, pancreatic (el-1), fecal; qualitative or semi-quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20922","name":"Removal of fascia for graft","description":"Fascia lata graft; by incision and area exposure, complex or sheet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2342.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25810","name":"Arthrd wrst iliac/oth agrft","description":"Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26536","name":"Revise/implant finger joint","description":"Arthroplasty, interphalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15120","name":"Splt agrft f/s/n/h/f/g/m 1st","description":"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36475","name":"Endovenous rf 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95904","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99412","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95976","name":"Alys smpl cn npgt prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81311","name":"Nras gene variants exon 2&3","description":"Nras (neuroblastoma ras viral [v-ras] oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP05","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35122","name":"Repair artery rupture belly","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, hepatic, celiac, renal, or mesenteric artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51728","name":"Cystometrogram w/vp","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53420","name":"Reconstruct urethra stage 1","description":"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81050","name":"Urinalysis volume measure","description":"Volume measurement for timed collection, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93355","name":"Echo transesophageal (tee)","description":"Echocardiography, transesophageal (tee) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, tavr, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial appendage occlusion/closure, ventricular septal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61316","name":"Inc&subq plmt crnl bone grf","description":"Incision and subcutaneous placement of cranial bone graft (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53447","name":"Remove/replace ur sphincter","description":"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93923","name":"Upr/lxtr art stdy 3+ lvls","description":"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional doppler wave","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27372","name":"Removal of foreign body","description":"Removal of foreign body, deep, thigh region or knee area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95808","name":"Polysom any age 1-3> param","description":"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33238","name":"Remove electrode/thoracotomy","description":"Removal of permanent transvenous electrode(s) by thoracotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27848","name":"Treat ankle dislocation","description":"Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; with repair or internal or external fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31579","name":"Laryngoscopy telescopic","description":"Laryngoscopy, flexible or rigid telescopic, with stroboscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62100","name":"Repair brain fluid leakage","description":"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1413.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58323","name":"Sperm washing","description":"Sperm washing for artificial insemination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54400","name":"Insert semi-rigid prosthesis","description":"Insertion of penile prosthesis; non-inflatable (semi-rigid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43270","name":"Egd lesion ablation","description":"Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1766.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43640","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":982.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1882.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9262.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67420","name":"Explore/treat eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15115","name":"Epdrm agrft f/s/n/h/f/g/m 1","description":"Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86765","name":"Rubeola antibody","description":"Antibody; rubeola","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KL","NU"]},{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0500","name":"Mod sedat endo service >5yrs","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousness ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"Pure tone hearing test air","description":"Screening test, pure tone, air only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42330","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35180","name":"Rpr cgen av fistula head&nck","description":"Repair, congenital arteriovenous fistula; head and neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99472","name":"Ped critical care subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33475","name":"Replacement pulmonary valve","description":"Replacement, pulmonary valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2024.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63102","name":"Remove vert body dcmprn lmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); lumbar, single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2003.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94452","name":"Hast w/i&r phys/qhp","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28192","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; deep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9131.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","name":"Scr mammo bi incl cad","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21616","name":"Exc 1st&/crv rib w/sympth","description":"Excision first and/or cervical rib; with sympathectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99412","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47511","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50075","name":"Nl rmvl lg staghorn calculus","description":"Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80196","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0197T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90865","name":"Narcosynthesis","description":"Narcosynthesis for psychiatric diagnostic and therapeutic purposes (eg, sodium amobarbital (amytal) interview)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50396","name":"Measure kidney pressure","description":"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2749.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1328.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","name":"Anes ther ivntl rad px icr","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96935","name":"Rcm img acquisj only ea addl","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition only, each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0424","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26861","name":"Fusion of finger jnt add-on","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; each additional interphalangeal joint (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","name":"Anes px art knee&pop nos","description":"Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63182","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1488.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32560","name":"Treat pleurodesis w/agent","description":"Instillation, via chest tube/catheter, agent for pleurodesis (eg, talc for recurrent or persistent pneumothorax)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67110","name":"Repair detached retina","description":"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62280","name":"Treat spinal cord lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15758","name":"Free fascial flap microvasc","description":"Free fascial flap with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29566.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36254","name":"Ins cath ren art 2nd+ bilat","description":"Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, an","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49424","name":"Assess cyst contrast inject","description":"Contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92015","name":"Determine refractive state","description":"Determination of refractive state","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74170","name":"Ct abd wo cntrst flwd cntrst","description":"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42830","name":"Removal of adenoids","description":"Adenoidectomy, primary; younger than age 12","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92134","name":"Cptrz oph dx img pst sgm rta","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37788","name":"Revascularization penis","description":"Penile revascularization, artery, with or without vein graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","name":"Anes xtrprt lwr abd prst8ect","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95834","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57558","name":"D&c of cervical stump","description":"Dilation and curettage of cervical stump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15838","name":"Exc excsv submental fat pad","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21435","name":"Optx crnfc sep comp int&/xtr","description":"Open treatment of craniofacial separation (lefort iii type); complicated, utilizing internal and/or external fixation techniques (eg, head cap, halo device, and/or intermaxillary fixation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33401","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0473","name":"Group behave couns 2-10","description":"Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83615","name":"Lactate (ld) (ldh) enzyme","description":"Lactate dehydrogenase (ld), (ldh);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4798.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50688","name":"Change of ureter tube/stent","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48153","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); with pancreatojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2598.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54000","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2064","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24366","name":"Reconstruct head of radius","description":"Arthroplasty, radial head; with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26542","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local tissue (eg, adductor advancement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15738","name":"Muscle-skin graft leg","description":"Muscle, myocutaneous, or fasciocutaneous flap; lower extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15176","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42210","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31239","name":"Nsl/sinus endoscopy surg dcr","description":"Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52640","name":"Relieve bladder contracture","description":"Transurethral resection; of postoperative bladder neck contracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3531.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0074A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50695","name":"Plmt ureteral stent prq","description":"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1126.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9983","name":"Remote e/m est. pt 10mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a problem focused history; a problem","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0246","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68362","name":"Revise eyelid lining","description":"Conjunctival flap; total (such as gunderson thin flap or purse string flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26200","name":"Remove hand bone lesion","description":"Excision or curettage of bone cyst or benign tumor of metacarpal;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42205","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19102","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93321","name":"Doppler echo f-up/lmtd std","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59856","name":"Induced ab 1+vag supp d&c","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61645","name":"Perq art m-thrombect &/nfs","description":"Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and intraprocedural pharmacological thrombolytic injection(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21825","name":"Treat sternum fracture","description":"Open treatment of sternum fracture with or without skeletal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10040","name":"Extraction","description":"Extraction (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86687","name":"Htlv-i antibody","description":"Antibody; htlv-i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72157","name":"Mri chest spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86703","name":"Hiv-1/hiv-2 1 result antbdy","description":"Antibody; hiv-1 and hiv-2, single result","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78459","name":"Myocrd img pet single study","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36140","name":"Intro ndl icath upr/lxtr art","description":"Introduction of needle or intracatheter, upper or lower extremity artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78831","name":"Rp loclzj tum spect 2 areas","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46600","name":"Diagnostic anoscopy spx","description":"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14040","name":"Tis trnfr f/c/c/m/n/a/g/h/f","description":"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44322","name":"Colostomy with biopsies","description":"Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73219","name":"Mri upper extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89235","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","BA","KE","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31605","name":"Emer tracheostomy cthyr mem","description":"Tracheostomy, emergency procedure; cricothyroid membrane","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40812","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76811","name":"Ob us detailed sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49540","name":"Repair lumbar hernia","description":"Repair lumbar hernia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61720","name":"Incise skull/brain surgery","description":"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85475","name":"Hemolysin acid","description":"Hemolysin, acid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27514","name":"Treatment of thigh fracture","description":"Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":820.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57510","name":"Cauterization of cervix","description":"Cautery of cervix; electro or thermal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33926","name":"Repr pul art unifocal w/cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2106.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43644","name":"Lap gastric bypass/roux-en-y","description":"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and roux-en-y gastroenterostomy (roux limb 150 cm or less)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87185","name":"Sc std enzyme detcj per nzm","description":"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27337","name":"Exc thigh/knee les sc 3 cm/>","description":"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77385","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60271","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25116","name":"Remove wrist/forearm lesion","description":"Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, tbc, or other granulomas, rheumatoid arthritis); extensors, with or without transposition of dorsal retinaculum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84442","name":"Assay of thyroid activity","description":"Thyroxine binding globulin (tbg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27269","name":"Optx thigh fx","description":"Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9490","name":"Cmmi mod home visit","description":"Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/man","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51729","name":"Cystometrogram w/vp&up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74363","name":"X-ray bile duct dilation","description":"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44158","name":"Colectomy w/neo-rectum pouch","description":"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, creation of ileal reservoir (s or j), includes loop ileostomy, and rectal mucosectomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1882.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35363","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliofemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81414","name":"Car ion chnnlpath inc 2 gns","description":"Cardiac ion channelopathies (eg, brugada syndrome, long qt syndrome, short qt syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include analysis of at least 2 genes, including kcnh2 and kcnq1","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76930","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92626","name":"Eval aud funcj 1st hour","description":"Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); first hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87557","name":"M.tuberculo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3203","name":"Oxford w/ supinator/pronator","description":"Orthopedic shoe, oxford with supinator or pronator, junior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88307","name":"Tissue exam by pathologist","description":"Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64832","name":"Repair nerve add-on","description":"Suture of digital nerve, hand or foot; each additional digital nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4730","name":"Fistula cannulation set, ea","description":"Fistula cannulation set for hemodialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64470","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86832","name":"Hla class i high defin qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, individual antigen per bead methodology), hla class i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35691","name":"Art trnsposj vertbrl carotid","description":"Transposition and/or reimplantation; vertebral to carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50240","name":"Nephrectomy partial","description":"Nephrectomy, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2341.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95714","name":"Veeg ea 12-26 hr unmntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, each increment of 12-26 hours; unmonitored","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69424","name":"Remove ventilating tube","description":"Ventilating tube removal requiring general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27808","name":"Treatment of ankle fracture","description":"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95967","name":"Meg evoked each addl","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38221","name":"Dx bone marrow biopsies","description":"Diagnostic bone marrow; biopsy(ies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96912","name":"Photochemotherapy puva","description":"Photochemotherapy; psoralens and ultraviolet a (puva)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74230","name":"X-ray xm swlng funcj c+","description":"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3112.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67880","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2325.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4671","name":"Disposable cycler set","description":"Disposable cycler set used with cycler dialysis machine, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32561","name":"Lyse chest fibrin init day","description":"Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); initial day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81177","name":"Atn1 gene detc abnor alleles","description":"Atn1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23420","name":"Repair of shoulder","description":"Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44320","name":"Colostomy","description":"Colostomy or skin level cecostomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43130","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43270","name":"Egd lesion ablation","description":"Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41007","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83901","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54135","name":"Remove penis & nodes","description":"Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1223.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53220","name":"Treatment of urethra lesion","description":"Excision or fulguration of carcinoma of urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61702","name":"Inner skull vessel surgery","description":"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3751.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","name":"Anes ivntl rad icr icar/aort","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or aortic","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65757","name":"Prep corneal endo allograft","description":"Backbench preparation of corneal endothelial allograft prior to transplantation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43286","name":"Esphg tot w/laps moblj","description":"Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, laparoscopic transhiatal esophagectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2627.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35681","name":"Composite byp grft pros&vein","description":"Bypass graft; composite, prosthetic and vein (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36870","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1468.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33645","name":"Revision of heart veins","description":"Direct or patch closure, sinus venosus, with or without anomalous pulmonary venous drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20220","name":"Bone biopsy trocar/ndl supfc","description":"Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24615","name":"Optx aqt/chrnc elbow dislc","description":"Open treatment of acute or chronic elbow dislocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31087","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":820.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93320","name":"Doppler echo complete","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49428","name":"Ligation of shunt","description":"Ligation of peritoneal-venous shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35621","name":"Bpg axillary-femoral","description":"Bypass graft, with other than vein; axillary-femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","name":"Anes dx/ther nrv blk&inj prn","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6747.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55810","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37227","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93544","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64721","name":"Carpal tunnel surgery","description":"Neuroplasty and/or transposition; median nerve at carpal tunnel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43770","name":"Lap place gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93272","name":"Ecg/review interpret only","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AV"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20206","name":"Biopsy muscle perq needle","description":"Biopsy, muscle, percutaneous needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57513","name":"Laser surgery of cervix","description":"Cautery of cervix; laser ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82677","name":"Assay of estriol","description":"Estriol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15277","name":"Skn sub grft f/n/hf/g child","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92562","name":"Loudness balance test","description":"Loudness balance test, alternate binaural or monaural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90849","name":"Multiple family group psytx","description":"Multiple-family group psychotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93461","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, cath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37780","name":"Revision of leg vein","description":"Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21138","name":"Rdctj forehead cntrg&prostc","description":"Reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22110","name":"Remove part of neck vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93461","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, cath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44605","name":"Repair of bowel lesion","description":"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40806","name":"Incision of lip fold","description":"Incision of labial frenum (frenotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25927","name":"Amputation of hand","description":"Transmetacarpal amputation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68110","name":"Exc les conjunctiva <1 cm","description":"Excision of lesion, conjunctiva; up to 1 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67145","name":"Proph rta dtchmnt pc","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22901","name":"Exc abdl tum deep 5 cm/>","description":"Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0199","name":"Med abortion inc all ex drug","description":"Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99184","name":"Hypothermia ill neonate","description":"Initiation of selective head or total body hypothermia in the critically ill neonate, includes appropriate patient selection by review of clinical, imaging and laboratory data, confirmation of esophageal temperature probe location, evaluation of amplitude eeg, supervision of controlled hypothermia, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93050","name":"Art pressure waveform analys","description":"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity art","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29440","name":"Adding walker to prev cast","description":"Adding walker to previously applied cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75658","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83735","name":"Assay of magnesium","description":"Magnesium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0318","name":"Prolong home eval add 15m","description":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11982","name":"Remove drug implant device","description":"Removal, non-biodegradable drug delivery implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82965","name":"Assay of gdh enzyme","description":"Glutamate dehydrogenase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0463","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45387","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87272","name":"Cryptosporidium ag if","description":"Infectious agent antigen detection by immunofluorescent technique; cryptosporidium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20665","name":"Rmvl tongs/halo anthr indiv","description":"Removal of tongs or halo applied by another individual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40527","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with cross lip flap (abbe-estlander)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25830","name":"Arthrd dst rad/ul jt sgm rsc","description":"Arthrodesis, distal radioulnar joint with segmental resection of ulna, with or without bone graft (eg, sauve-kapandji procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65270","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44144","name":"Partial removal of colon","description":"Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78472","name":"Gated heart planar single","description":"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87470","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33332","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27496","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72130","name":"Ct chest spine w/o & w/dye","description":"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15121","name":"Splt agrft f/s/n/h/f/g/m ea","description":"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20501","name":"Njx sinus tract diagnostic","description":"Injection of sinus tract; diagnostic (sinogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1978.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92226","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2466.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53665","name":"Dilation of urethra","description":"Dilation of female urethra, general or conduction (spinal) anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9037","name":"Plate pheres leukoredu irrad","description":"Platelets, pheresis, leukocytes reduced, irradiated, each unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11306","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62143","name":"Rpl b1 flp/prostc plate skl","description":"Replacement of bone flap or prosthetic plate of skull","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52400","name":"Cysto cgen post urtl valves","description":"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99234","name":"Hosp ip/obs sm dt sf/low 45","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9502","name":"Tc99m tetrofosmin","description":"Technetium tc-99m tetrofosmin, diagnostic, per study dose","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78227","name":"Hepatobil syst image w/drug","description":"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23405","name":"Incision of tendon & muscle","description":"Tenotomy, shoulder area; single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95719","name":"Eeg phys/qhp ea incr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of eeg recording, interpretation and report after each 24-hour period; w","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95870","name":"Ndl emg lmtd std musc 1 xtr","description":"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25300","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; flexors of fingers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61542","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1721.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33416","name":"Revise ventricle muscle","description":"Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis (eg, asymmetric septal hypertrophy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1755.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33335","name":"Insert major vessel graft","description":"Insertion of graft, aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1623.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40842","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28140","name":"Removal of metatarsal","description":"Metatarsectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61880","name":"Revise/remove neuroelectrode","description":"Revision or removal of intracranial neurostimulator electrodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93286","name":"Peri-px eval pm/ldls pm ip","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead pacemaker system, or leadless pacemaker ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0107T","name":"Vibrate quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using vibration stimuli to assess large diameter fiber sensation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36555","name":"Insert non-tunnel cv cath","description":"Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98970","name":"Nqhp ol dig assmt&mgmt 5-10","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3909.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":9645.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93316","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36515","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42845","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1731.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01230","name":"Anes opn upper 2/3 femur nos","description":"Anesthesia for open procedures involving upper two-thirds of femur; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1510","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62380","name":"Ndsc dcmprn 1 ntrspc lumbar","description":"Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01931","name":"Anes ivnt rad ntrhpt/prt crc","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrahepatic or portal circulation (eg, transvenous intrahepatic portosystemic shunt[s] [tips])","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21920","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27580","name":"Fusion of knee","description":"Arthrodesis, knee, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1234.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64868","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-hypoglossal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64832","name":"Repair nerve add-on","description":"Suture of digital nerve, hand or foot; each additional digital nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52300","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27637","name":"Remove/graft leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72146","name":"Mri chest spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]},{"negotiated_type":"negotiated","negotiated_rate":191.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61304","name":"Crnec/crnot expl supratntorl","description":"Craniectomy or craniotomy, exploratory; supratentorial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87260","name":"Adenovirus ag if","description":"Infectious agent antigen detection by immunofluorescent technique; adenovirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92100","name":"Serial tonometry","description":"Serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day (eg, diurnal curve or medical treatment of acute elevation of intraocular pressure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67917","name":"Repair eyelid defect","description":"Repair of ectropion; extensive (eg, tarsal strip operations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27488","name":"Removal of knee prosthesis","description":"Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1016.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","name":"Anes vaginal px nos","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25375","name":"Revise radius & ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius and ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83690","name":"Assay of lipase","description":"Lipase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39560","name":"Resect diaphragm simple","description":"Resection, diaphragm; with simple repair (eg, primary suture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2554.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10160","name":"Pnxr aspir absc hmtma bulla","description":"Puncture aspiration of abscess, hematoma, bulla, or cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99490","name":"Chrnc care mgmt staff 1st 20","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84160","name":"Assay of protein any source","description":"Protein, total, by refractometry, any source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54050","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44408","name":"Colonoscopy w/decompression","description":"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99465","name":"Nb resuscitation","description":"Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92996","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3268.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87531","name":"Hhv-6 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":302.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26480","name":"Transplant hand tendon","description":"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41100","name":"Biopsy of tongue","description":"Biopsy of tongue; anterior two-thirds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14000","name":"Tis trnfr trunk 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84106","name":"Test for porphobilinogen","description":"Porphobilinogen, urine; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31233","name":"Nsl/sins ndsc dx max sinusc","description":"Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy (via inferior meatus or canine fossa puncture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62305","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61107","name":"Tdh pnxr implt ventr cath","description":"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75992","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01484","name":"Anes opn lw l/a/f oste/ostpl","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99336","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70542","name":"Mri orbit/face/neck w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65103","name":"Remove eye/insert implant","description":"Enucleation of eye; with implant, muscles not attached to implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","name":"Neuraxl lbr anes vag dlvr","description":"Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50976","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70546","name":"Mr angiograph head w/o&w/dye","description":"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78480","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4538","name":"Diaper serv reusable diaper","description":"Diaper service, reusable diaper, each diaper","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49555","name":"Rerepair fem hernia reduce","description":"Repair recurrent femoral hernia; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65770","name":"Keratoprosthesis","description":"Keratoprosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93015","name":"Cv stress test supvj i&r","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67031","name":"Laser surgery eye strands","description":"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32504","name":"Resect apical lung tum/chest","description":"Resection of apical lung tumor (eg, pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; with chest wall reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1639.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86900","name":"Blood typing serologic abo","description":"Blood typing, serologic; abo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97608","name":"Neg prs wnd ther ndme>50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62142","name":"Rmvl b1 flp/prostc plate skl","description":"Removal of bone flap or prosthetic plate of skull","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":796.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23332","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27750","name":"Treatment of tibia fracture","description":"Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93282","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51065","name":"Remove ureter calculus","description":"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88371","name":"Protein western blot tissue","description":"Protein analysis of tissue by western blot, with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31766","name":"Carinal reconstruction","description":"Carinal reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1423.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0236T","name":"Trluml perip athrc abd aorta","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; abdominal aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9507.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78586","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57545","name":"Remove cervix/repair pelvis","description":"Excision of cervical stump, abdominal approach; with pelvic floor repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34707","name":"Evasc rpr ilio-iliac ndgft","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1016.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37238","name":"Open/perq place stent same","description":"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26720","name":"Treat finger fracture each","description":"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; without manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31627","name":"Navigational bronchoscopy","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation (list separately in addition to code for primary procedure[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","name":"Anes upr lwr gi ndsc px","description":"Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50722","name":"Release of ureter","description":"Ureterolysis for ovarian vein syndrome","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22904","name":"Radical resect abd tumor<5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99144","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93290","name":"Interrog dev eval icpms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular physiologic monitor system, including analysis of 1 or more reco","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3588.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50825","name":"Construct bowel bladder","description":"Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (kock pouch or camey enterocystoplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65275","name":"Repair of eye wound","description":"Repair of laceration; cornea, nonperforating, with or without removal foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20690","name":"Appl unipln uni ext fixj sys","description":"Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86903","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21010","name":"Incision of jaw joint","description":"Arthrotomy, temporomandibular joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97124","name":"Massage therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53275","name":"Repair of urethra defect","description":"Excision or fulguration; urethral prolapse","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0232T","name":"Njx platelet plasma","description":"Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30160","name":"Rhinectomy total","description":"Rhinectomy; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8914","name":"Mra w/o fol w/cont, lwr ext","description":"Magnetic resonance angiography without contrast followed by with contrast, lower extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99480","name":"Sbsq ic inf pbw 2,501-5,000","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2,501-5,000 grams)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78816","name":"Pet image w/ct full body","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90913","name":"Bfb training ea addl 15 min","description":"Biofeedback training, perineal muscles, anorectal or urethral sphincter, including emg and/or manometry, when performed; each additional 15 minutes of one-on-one physician or other qualified health care professional contact with the patient (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86717","name":"Leishmania antibody","description":"Antibody; leishmania","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87906","name":"Nfct agt gntyp alys hiv1","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hiv-1, other region (eg, integrase, fusion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0443","name":"Brief alcohol misuse counsel","description":"Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93288","name":"Interrog evl pm/ldls pm ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system, or leadless pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47765","name":"Fuse liver ducts & bowel","description":"Anastomosis, of intrahepatic ducts and gastrointestinal tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2559.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72084","name":"X-ray exam entire spi 6/> vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8645.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67515","name":"Inject/treat eye socket","description":"Injection of medication or other substance into tenons capsule","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11266.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86781","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570T","name":"Ttvr perq ea addl prosth","description":"Transcatheter tricuspid valve repair, percutaneous approach; each additional prosthesis during same session (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22328","name":"Treat each add spine fx","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebra or dislocated segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86294","name":"Immunoassay tumor qual","description":"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15951","name":"Exc trchntr pr ulc ostc","description":"Excision, trochanteric pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2042.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73221","name":"Mri joint upr extrem w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38550","name":"Removal neck/armpit lesion","description":"Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69421","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12013","name":"Rpr f/e/e/n/l/m 2.6-5.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78802","name":"Rp loclzj tum whbdy 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2160.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61590","name":"Infratemporal approach/skull","description":"Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parotidectomy, craniotomy, decompression and/or mobilization of the facial nerve and/or petrous carotid a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2557.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5233.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32667","name":"Thoracoscopy w/w resect addl","description":"Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26185","name":"Remove finger bone","description":"Sesamoidectomy, thumb or finger (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48155","name":"Removal of pancreas","description":"Pancreatectomy, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1509.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","name":"Anes integ sys rad/modf brst","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12032","name":"Intmd rpr s/a/t/ext 2.6-7.5","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8911","name":"Mra w/o fol w/cont, chest","description":"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1632.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","name":"Anes px male gent orchiopexy","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65210","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1206.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82626","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone (dhea)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31090","name":"Exploration of sinuses","description":"Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61783","name":"Scan proc spinal","description":"Stereotactic computer-assisted (navigational) procedure; spinal (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85002","name":"Bleeding time test","description":"Bleeding time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87900","name":"Phenotype infect agent drug","description":"Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53440","name":"Male sling procedure","description":"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0082","name":"Care man h v ext pt 30 m","description":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27829","name":"Treat lower leg joint","description":"Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64568","name":"Opn impltj crnl nrv nea&pg","description":"Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96573","name":"Pdt dstr prmlg les phys/qhp","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36415","name":"Coll venous bld venipuncture","description":"Collection of venous blood by venipuncture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95885","name":"Musc tst done w/nerv tst lim","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49491","name":"Rpr hern preemie reduc","description":"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00942","name":"Anes vag px clptmy vgnc clpr","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); colpotomy, vaginectomy, colporrhaphy, and open urethral procedures","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","name":"Anes trurl px urtrl cal rmvl","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80438","name":"Trh stimulation panel","description":"Thyrotropin releasing hormone (trh) stimulation panel; 1 hour this panel must include the following: thyroid stimulating hormone (tsh) (84443 x 3)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","name":"Anes vaginal px nos","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32815","name":"Close bronchial fistula","description":"Open closure of major bronchial fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2241.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28047","name":"Resect foot/toe tumor 3 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46500","name":"Injection into hemorrhoid(s)","description":"Injection of sclerosing solution, hemorrhoids","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87250","name":"Virus inoculate eggs/animal","description":"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96936","name":"Rcm i&r only ea addl lesion","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; interpretation and report only, each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60280","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15121","name":"Splt agrft f/s/n/h/f/g/m ea","description":"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26434","name":"Repair/graft finger tendon","description":"Repair of extensor tendon, distal insertion, primary or secondary; with free graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19318","name":"Breast reduction","description":"Breast reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65820","name":"Goniotomy","description":"Goniotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2500.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4537","name":"Reusable underpad bed size","description":"Incontinence product, protective underpad, reusable, bed size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15935","name":"Exc sac pr ulc skn flp ostc","description":"Excision, sacral pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":357.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4213","name":"20+ cc syringe only","description":"Syringe, sterile, 20 cc or greater, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47122","name":"Extensive removal of liver","description":"Hepatectomy, resection of liver; trisegmentectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2874.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54860","name":"Removal of epididymis","description":"Epididymectomy; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84078","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline; heat stable (total not included)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10009","name":"Fna bx w/ct gdn 1st les","description":"Fine needle aspiration biopsy, including ct guidance; first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4522","name":"Adult size brief/diaper med","description":"Adult sized disposable incontinence product, brief/diaper, medium, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43254","name":"Egd endo mucosal resection","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30160","name":"Rhinectomy total","description":"Rhinectomy; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0429","name":"Dermal filler injection(s)","description":"Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88307","name":"Tissue exam by pathologist","description":"Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93289","name":"Interrog device eval heart","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including anal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"Esrd srv 4 visits p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63001","name":"Remove spine lamina 1/2 crvl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31620","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50694","name":"Plmt ureteral stent prq","description":"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35483","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67906","name":"Repair eyelid defect","description":"Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44394","name":"Colonoscopy w/snare","description":"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58920","name":"Partial removal of ovary(s)","description":"Wedge resection or bisection of ovary, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78803","name":"Rp loclzj tum spect 1 area","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89140","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76828","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4614.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4798.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45560","name":"Repair of rectocele","description":"Repair of rectocele (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27632","name":"Exc leg/ankle les sc 3 cm/>","description":"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27530","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2002","name":"Post-d/c h vst new pt 30 m","description":"Limited (30 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75650","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99232","name":"Sbsq hosp ip/obs moderate 35","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minut","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4337.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6784.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83950","name":"Oncoprotein her-2/neu","description":"Oncoprotein; her-2/neu","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47001","name":"Ndl biopsy lvr tm oth maj px","description":"Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37212","name":"Thrombolytic venous therapy","description":"Transcatheter therapy, venous infusion for thrombolysis, any method, including radiological supervision and interpretation, initial treatment day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27780","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49460","name":"Fix g/colon tube w/device","description":"Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including contrast injection(s), if performed, image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1539.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4383.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20924","name":"Removal of tendon for graft","description":"Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43620","name":"Removal of stomach","description":"Gastrectomy, total; with esophagoenterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1666.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4721","name":"Dialysat sol fld vol > 999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81173","name":"Ar gene full gene sequence","description":"Ar (androgen receptor) (eg, spinal and bulbar muscular atrophy, kennedy disease, x chromosome inactivation) gene analysis; full gene sequence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32856","name":"Prepare donor lung double","description":"Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88363","name":"Xm archive tissue molec anal","description":"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44372","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0147","name":"Scr c/v cyto, automated sys","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33216","name":"Insert 1 electrode pm-defib","description":"Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32442","name":"Sleeve pneumonectomy","description":"Removal of lung, pneumonectomy; with resection of segment of trachea followed by broncho-tracheal anastomosis (sleeve pneumonectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2461.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1712.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38790","name":"Inject for lymphatic x-ray","description":"Injection procedure; lymphangiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40808","name":"Biopsy of mouth lesion","description":"Biopsy, vestibule of mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64856","name":"Repair/transpose nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23465","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C2617","name":"Stent, non-cor, tem w/o del","description":"Stent, non-coronary, temporary, without delivery system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85635","name":"Reptilase test","description":"Reptilase test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33675","name":"Close mult vsd","description":"Closure of multiple ventricular septal defects;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1715.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86622","name":"Brucella antibody","description":"Antibody; brucella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01810","name":"Anes px nrv musc f/arm wrst","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54161","name":"Circum 28 days or older","description":"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92582","name":"Conditioning play audiometry","description":"Conditioning play audiometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1638.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61886","name":"Implant neurostim arrays","description":"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51797","name":"Intraabdominal pressure test","description":"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93460","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0114","name":"Fern test","description":"Fern test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78414","name":"Non-imaging heart function","description":"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31595","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93452","name":"Left hrt cath w/ventrclgrphy","description":"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0289","name":"Arthro, loose body + chondro","description":"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93458","name":"L hrt artery/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0404","name":"Ekg tracing for initial prev","description":"Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74247","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95962","name":"Electrode stim brain add-on","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92072","name":"Fitg c-lens keratoconus 1st","description":"Fitting of contact lens for management of keratoconus, initial fitting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1291.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32657","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45112","name":"Removal of rectum","description":"Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1489.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89331","name":"Retrograde ejaculation anal","description":"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75961","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4855.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75571","name":"Ct hrt w/o dye w/ca test","description":"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29515","name":"Application short leg splint","description":"Application of short leg splint (calf to foot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54105","name":"Biopsy of penis","description":"Biopsy of penis; deep structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25431","name":"Repair nonunion carpal bone","description":"Repair of nonunion of carpal bone (excluding carpal scaphoid (navicular)) (includes obtaining graft and necessary fixation), each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4732.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54435","name":"Revision of penis","description":"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, winter procedure, rongeur, or punch) for priapism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76813","name":"Ob us nuchal meas 1 gest","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3744.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86625","name":"Campylobacter antibody","description":"Antibody; campylobacter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94662","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41105","name":"Biopsy of tongue","description":"Biopsy of tongue; posterior one-third","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","name":"Anes opn px upr tib fib&/pat","description":"Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":54.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27045","name":"Exc hip/pelv tum deep 5 cm/>","description":"Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27727","name":"Repair of lower leg","description":"Repair of congenital pseudarthrosis, tibia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84035","name":"Assay of phenylketones","description":"Phenylketones, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40525","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with local flap (eg, estlander or fan)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99423","name":"Ol dig e/m svc 21+ min","description":"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11000","name":"Dbrdmt ecz/infected skin<10%","description":"Debridement of extensive eczematous or infected skin; up to 10% of body surface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80150","name":"Assay of amikacin","description":"Amikacin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6202","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01470","name":"Anes px nrv msc lw l/a/f nos","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5960.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32554","name":"Aspirate pleura w/o imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2072.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2861","name":"Torsion mechanism knee/ankle","description":"Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74221","name":"X-ray xm esophagus 2cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37231","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9604","name":"One-way allow prorated trip","description":"Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31760","name":"Tracheoplasty intrathoracic","description":"Tracheoplasty; intrathoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":310.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4245","name":"Alcohol wipes per box","description":"Alcohol wipes, per box","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23900","name":"Interthoracoscplr amputation","description":"Interthoracoscapular amputation (forequarter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28118","name":"Removal of heel bone","description":"Ostectomy, calcaneus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3415.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60521","name":"Removal of thymus gland","description":"Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6086.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2467.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30115","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), extensive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95938","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63196","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1627.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30930","name":"Ther fx nasal inf turbinate","description":"Fracture nasal inferior turbinate(s), therapeutic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46260","name":"Remove in/ex hem groups 2+","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19101","name":"Biopsy of breast open","description":"Biopsy of breast; open, incisional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61323","name":"Crnec/crnot dcmprv w/lobec","description":"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2202.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61684","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2621.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85292","name":"Clot factor fletcher fact","description":"Clotting; prekallikrein assay (fletcher factor assay)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64766","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35281","name":"Rpr blvsl gr ot/th vn ntr-ab","description":"Repair blood vessel with graft other than vein; intra-abdominal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6000","name":"Wound warming wound cover","description":"Non-contact wound warming wound cover for use with the non-contact wound warming device and warming card","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27446","name":"Revision of knee joint","description":"Arthroplasty, knee, condyle and plateau; medial or lateral compartment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61586","name":"Resect nasopharynx skull","description":"Bicoronal, transzygomatic and/or lefort i osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75946","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01610","name":"Anes all px nrv musc sho&ax","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24370","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57330","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; transvesical and vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99308","name":"Sbsq nf care low mdm 20","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exce","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35475","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86023","name":"Immunoglobulin assay","description":"Antibody identification; platelet associated immunoglobulin assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28715.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46601","name":"Diagnostic anoscopy","description":"Anoscopy; diagnostic, with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78270","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2251","name":"Brief chkin, 5-10, non-e/m","description":"Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99326","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98926","name":"Osteopath manj 3-4 regions","description":"Osteopathic manipulative treatment (omt); 3-4 body regions involved","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40801","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; office type procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29055","name":"Appl cast shoulder spica","description":"Application, cast; shoulder spica","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21208","name":"Augmentation of facial bones","description":"Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97166","name":"Ot eval mod complex 45 min","description":"Occupational therapy evaluation, moderate complexity, requiring these components: an occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy records and additional review of physical, cognitive, or psychosocial history related to current func","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1627.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57300","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; vaginal or transanal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87807","name":"Rsv assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26590","name":"Repair finger deformity","description":"Repair macrodactylia, each digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82543","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29819","name":"Sho arthrs srg rmvl loose/fb","description":"Arthroscopy, shoulder, surgical; with removal of loose body or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4216","name":"Parenteral nutrition additiv","description":"Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93454","name":"Coronary artery angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":214.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93976","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2005","name":"Post-d/c h vst new pt 75 m","description":"Extensive (75 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34709","name":"Plmt xtn prosth evasc rpr","description":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselec","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45317","name":"Proctosigmoidoscopy bleed","description":"Proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82664","name":"Electrophoretic test","description":"Electrophoretic technique, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97763","name":"Orthc/prostc mgmt sbsq enc","description":"Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5693.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1311.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43831","name":"Gastrostomy open neonatal","description":"Gastrostomy, open; neonatal, for feeding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35693","name":"Art trnsposj subclavian","description":"Transposition and/or reimplantation; vertebral to subclavian artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64786","name":"Remove sciatic nerve lesion","description":"Excision of neuroma; sciatic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46730","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; perineal or sacroperineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60520","name":"Removal of thymus gland","description":"Thymectomy, partial or total; transcervical approach (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70496","name":"Ct angiography head","description":"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14696.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26675","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99172","name":"Ocular function screen","description":"Visual function screening, automated or semi-automated bilateral quantitative determination of visual acuity, ocular alignment, color vision by pseudoisochromatic plates, and field of vision (may include all or some screening of the determination[s] for contrast sensitivity, vision under glare)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73225","name":"Mr angio upr extr w/o&w/dye","description":"Magnetic resonance angiography, upper extremity, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92613","name":"Endoscopy swallow (fees) i&r","description":"Flexible endoscopic evaluation of swallowing by cine or video recording; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43244","name":"Egd varices ligation","description":"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21073","name":"Mnpj of tmj w/anesth","description":"Manipulation of temporomandibular joint(s) (tmj), therapeutic, requiring an anesthesia service (ie, general or monitored anesthesia care)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46255","name":"Remove int/ext hem 1 group","description":"Hemorrhoidectomy, internal and external, single column/group;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70482","name":"Ct orbit/ear/fossa w/o&w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8688","name":"Implt nrostm pls gen dua non","description":"Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82355","name":"Calculus analysis qual","description":"Calculus; qualitative analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93464","name":"Exercise w/hemodynamic meas","description":"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39531","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3700","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80053","name":"Comprehen metabolic panel","description":"Comprehensive metabolic panel this panel must include the following: albumin (82040) bilirubin, total (82247) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphatase, alkaline (84075) potassium (84132) protein, total (84155) sodium ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67331","name":"Eye surgery follow-up add-on","description":"Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47381","name":"Open ablate liver tumor cryo","description":"Ablation, open, of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56501","name":"Destroy vulva lesions sim","description":"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3728.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96920","name":"Excimer lsr psriasis<250sqcm","description":"Excimer laser treatment for psoriasis; total area less than 250 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19084","name":"Bx breast add lesion us imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including ultrasound guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","name":"Anes px hrt w/pump age 1yr+","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92286","name":"Ant sgm img i&r speclr mic","description":"Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24100","name":"Arthrt elbw synovial bx only","description":"Arthrotomy, elbow; with synovial biopsy only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75559","name":"Cardiac mri w/stress img","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43300","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5980.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","name":"Anes opn rpr fx disrpj plvs","description":"Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0885","name":"Pwc gp4 std mult pow opt cap","description":"Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43331","name":"Esophagomyotomy thoracic","description":"Esophagomyotomy (heller type); thoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35480","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42826","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; age 12 or over","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36597","name":"Reposition venous catheter","description":"Repositioning of previously placed central venous catheter under fluoroscopic guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84300","name":"Assay of urine sodium","description":"Sodium; urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93722","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70546","name":"Mr angiograph head w/o&w/dye","description":"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37160","name":"Revision of circulation","description":"Venous anastomosis, open; caval-mesenteric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","name":"Anes cls px upr tib fib&/pat","description":"Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78478","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43233","name":"Egd balloon dil esoph30 mm/>","description":"Esophagogastroduodenoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5429.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12056","name":"Intmd rpr face/mm 20.1-30.0","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31717","name":"Bronchial brush biopsy","description":"Catheterization with bronchial brush biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93236","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4490","name":"Above knee surgical stocking","description":"Surgical stockings above knee length, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45331","name":"Sigmoidoscopy and biopsy","description":"Sigmoidoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80198","name":"Assay of theophylline","description":"Theophylline","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92979","name":"Endoluminl ivus oct c ea","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to co","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15836","name":"Exc excessive skin arm","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82658","name":"Enzyme cell activity ra","description":"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50070","name":"Nl comp cgen kdn abnormality","description":"Nephrolithotomy; complicated by congenital kidney abnormality","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67505","name":"Inject/treat eye socket","description":"Retrobulbar injection; alcohol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43631","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastroduodenostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1211.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80414","name":"Testosterone response panel","description":"Chorionic gonadotropin stimulation panel; testosterone response this panel must include the following: testosterone (84403 x 2 on 3 pooled blood samples)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2549.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3179.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64421","name":"Njx aa&/strd ntrcost nrv ea","description":"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2061.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80160","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21461","name":"Optx mndblr fx wo ntrdntl","description":"Open treatment of mandibular fracture; without interdental fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27067","name":"Remove/graft hip bone lesion","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; with autograft requiring separate incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11401","name":"Exc tr-ext b9+marg 0.6-1 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11200","name":"Rmvl skin tags up to&inc 15","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47537","name":"Removal biliary drg cath","description":"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92614","name":"Laryngoscopic sensory vid","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15920","name":"Exc coccygl pr ulc prim sutr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with primary suture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480T","name":"Fxjl abl lsr ea addl 100sqcm","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2, or each additional 1% of body surface area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64421","name":"Njx aa&/strd ntrcost nrv ea","description":"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45915","name":"Remove rectal obstruction","description":"Removal of fecal impaction or foreign body (separate procedure) under anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67830","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74241","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55110","name":"Explore scrotum","description":"Scrotal exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95131","name":"Immntx 2 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 2 stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33516","name":"Cabg vein six or more","description":"Coronary artery bypass, vein only; 6 or more coronary venous grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2354.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80172","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15823","name":"Blepharp upr eyelid xcsv skn","description":"Blepharoplasty, upper eyelid; with excessive skin weighting down lid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22515","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; each additional thoracic or lumbar vertebra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52320","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13102","name":"Cmplx rpr trunk addl 5cm/<","description":"Repair, complex, trunk; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43269","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68100","name":"Biopsy conjunctiva","description":"Biopsy of conjunctiva","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97022","name":"Whirlpool therapy","description":"Application of a modality to 1 or more areas; whirlpool","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23465","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15933","name":"Exc sac pr ulc prim str ostc","description":"Excision, sacral pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","name":"Anes lwr intst ndsc nos","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15774","name":"Gfrg autol fat lipo ea addl","description":"Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27497","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor); with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1809.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38381","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; thoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87101","name":"Skin fungi culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11363.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74713","name":"Mri fetal ea addl gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83670","name":"Assay of lap enzyme","description":"Leucine aminopeptidase (lap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43107","name":"Removal of esophagus","description":"Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2482.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63276","name":"Bx/exc xdrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1623.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":129.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45111","name":"Partial removal of rectum","description":"Proctectomy; partial resection of rectum, transabdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85045","name":"Automated reticulocyte count","description":"Blood count; reticulocyte, automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0143","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67141","name":"Proph rta dtchmnt crtx dthrm","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61750","name":"Incise skull/brain biopsy","description":"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1285.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"Prev visit new age 12-17","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77058","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64726","name":"Dcmprn plantar digital nerve","description":"Decompression; plantar digital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1840.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26460","name":"Incise hand/finger tendon","description":"Tenotomy, extensor, hand or finger, open, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82552","name":"Assay of cpk in blood","description":"Creatine kinase (ck), (cpk); isoenzymes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51797","name":"Intraabdominal pressure test","description":"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1707.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21230","name":"Rib cartilage graft","description":"Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42235","name":"Repair palate","description":"Repair of anterior palate, including vomer flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92317","name":"C-lens fitg tech corneosclrl","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneoscleral lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KF","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32095","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33517","name":"Cabg artery-vein single","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26498","name":"Finger tendon transfer","description":"Transfer of tendon to restore intrinsic function; all 4 fingers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93641","name":"Ep evl 1/2chmb pac cvdfb tst","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22110","name":"Remove part of neck vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29520","name":"Strapping of hip","description":"Strapping; hip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26205","name":"Remove/graft bone lesion","description":"Excision or curettage of bone cyst or benign tumor of metacarpal; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17855.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"Esrd svc pr day pt 20+","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 20 years of age and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["GT","95","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5783.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22310","name":"Closed tx vert fx w/o manj","description":"Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33020","name":"Incision of heart sac","description":"Pericardiotomy for removal of clot or foreign body (primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95709","name":"Eeg w/o vid ea 12-26hr intmt","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, each increment of 12-26 hours; with intermittent monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62162","name":"Remove colloid cyst w/scope","description":"Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1727.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1457.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83872","name":"Assay synovial fluid mucin","description":"Mucin, synovial fluid (ropes test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3157.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93272","name":"Ecg/review interpret only","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81539","name":"Oncology prostate prob score","description":"Oncology (high-grade prostate cancer), biochemical assay of four proteins (total psa, free psa, intact psa, and human kallikrein-2 [hk2]), utilizing plasma or serum, prognostic algorithm reported as a probability score","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76811","name":"Ob us detailed sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78587","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51772","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87532","name":"Hhv-6 dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51729","name":"Cystometrogram w/vp&up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92537","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1376.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80048","name":"Basic metabolic pnl total ca","description":"Basic metabolic panel (calcium, total) this panel must include the following: calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78480","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5160.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2718.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95934","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24560","name":"Cltx hum epcndylr fx wo mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92549","name":"Cdp-sot 6 cond w/i&r mct&adt","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (mct) and adaptation test (adt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81186","name":"Cacna1a gen known famil vrnt","description":"Cacna1a (calcium voltage-gated channel subunit alpha1 a) (eg, spinocerebellar ataxia) gene analysis; known familial variant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84540","name":"Assay of urine/urea-n","description":"Urea nitrogen, urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71090","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27705","name":"Osteotomy tibia","description":"Osteotomy; tibia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93652","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01850","name":"Anes vein f/arm wrst&hnd nos","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44394","name":"Colonoscopy w/snare","description":"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96402","name":"Chemo hormon antineopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85293","name":"Clot factor wght kininogen","description":"Clotting; high molecular weight kininogen assay (fitzgerald factor assay)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83631","name":"Lactoferrin fecal (quant)","description":"Lactoferrin, fecal; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99291","name":"Critical care first hour","description":"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":438.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83088","name":"Assay of histamine","description":"Histamine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3003.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]},{"negotiated_type":"negotiated","negotiated_rate":1288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24126","name":"Exc/crtg b1 cst/tum rds algr","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27176","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by single or multiple pinning, in situ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25505","name":"Cltx rdl shft fx w/mnpj","description":"Closed treatment of radial shaft fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27704","name":"Removal of ankle implant","description":"Removal of ankle implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28261","name":"Revision of foot tendon","description":"Capsulotomy, midfoot; with tendon lengthening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93609","name":"Intra-vntr mapg tchycar site","description":"Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25332","name":"Revise wrist joint","description":"Arthroplasty, wrist, with or without interposition, with or without external or internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27613","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L6639","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61544","name":"Remove & treat brain lesion","description":"Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1741.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15274","name":"Skn sub grft t/a/l child add","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35840","name":"Explore abdominal vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1044.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93572","name":"Iv dop vel&/press c flo ea","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25624","name":"Cltx carpl scphd fx w/mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00934","name":"Anes rad amp penis ingun lym","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":24.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20662","name":"Application halo pelvic","description":"Application of halo, including removal; pelvic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31297","name":"Nsl/sins ndsc surg sphn sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); sphenoid sinus ostium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35226","name":"Repair blood vessel dir lxtr","description":"Repair blood vessel, direct; lower extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58550","name":"Laparo-asst vag hysterectomy","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35665","name":"Bpg iliofemoral","description":"Bypass graft, with other than vein; iliofemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99155","name":"Mod sed oth phys/qhp <5 yrs","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient younger th","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25145","name":"Remove forearm bone lesion","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0402","name":"Initial preventive exam","description":"Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","name":"Anes clsd ch mediast&thrc w/","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82926","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33305","name":"Repair of heart wound","description":"Repair of cardiac wound; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3585.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59120","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27703","name":"Reconstruction ankle joint","description":"Arthroplasty, ankle; revision, total ankle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92987","name":"Revision of mitral valve","description":"Percutaneous balloon valvuloplasty; mitral valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53415","name":"Reconstruction of urethra","description":"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":914.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71022","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2842.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95708","name":"Eeg wo vid ea 12-26hr unmntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, each increment of 12-26 hours; unmonitored","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37211","name":"Thrombolytic art therapy","description":"Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38209","name":"Wash harvest stem cells","description":"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing, per donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":939.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1782.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","name":"Anes hrna rpr<37wk brth<50","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4263","name":"Permanent tear duct plug","description":"Permanent, long term, non-dissolvable lacrimal duct implant, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21267","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1304.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35901","name":"Excision graft neck","description":"Excision of infected graft; neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58270","name":"Vag hyst w/enterocele repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61333","name":"Expl orbit w/removal lesion","description":"Exploration of orbit (transcranial approach), with removal of lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17463.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4222","name":"Parenteral supply kit homemi","description":"Parenteral nutrition supply kit; home mix, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33782","name":"Nikaidoh proc","description":"Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, nikaidoh procedure); without coronary ostium reimplantation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2820.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14301","name":"Tis trnfr any 30.1-60 sq cm","description":"Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","name":"Anes art f/arm wrst&hnd nos","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88249","name":"Chromosome analysis 100","description":"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin c, ionizing radiation, uv radiation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95925","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96409","name":"Chemo iv push sngl drug","description":"Chemotherapy administration; intravenous, push technique, single or initial substance/drug","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33502","name":"Coronary artery correction","description":"Repair of anomalous coronary artery from pulmonary artery origin; by ligation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82030","name":"Assay of adp & amp","description":"Adenosine, 5-monophosphate, cyclic (cyclic amp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57295","name":"Revise vag graft via vagina","description":"Revision (including removal) of prosthetic vaginal graft; vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20973","name":"Bone/skin graft great toe","description":"Free osteocutaneous flap with microvascular anastomosis; great toe with web space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2557.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28005","name":"Treat foot bone lesion","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84620","name":"Xylose tolerance test","description":"Xylose absorption test, blood and/or urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7981.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":15151.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43045","name":"Esophagotomy thrc rmvl fb","description":"Esophagotomy, thoracic approach, with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93290","name":"Interrog dev eval icpms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular physiologic monitor system, including analysis of 1 or more reco","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70492","name":"Ct sft tsue nck w/o & w/dye","description":"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81285","name":"Fxn gene charac alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20931","name":"Sp bone algrft struct add-on","description":"Allograft, structural, for spine surgery only (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92134","name":"Cptrz oph dx img pst sgm rta","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27090","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9262.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82495","name":"Assay of chromium","description":"Chromium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50940","name":"Release of ureter","description":"Deligation of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4775.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23460.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41113","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; posterior one-third","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70554","name":"Fmri brain by tech","description":"Magnetic resonance imaging, brain, functional mri; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95803","name":"Actigraphy testing","description":"Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29365","name":"Appl cylinder cast","description":"Application of cylinder cast (thigh to ankle)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91013","name":"Esophgl motil w/stim/perfus","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73718","name":"Mri lower extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9980","name":"Remote e/m new pt 30 mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed examination; medical decision making","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26499","name":"Correction claw finger other","description":"Correction claw finger, other methods","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53270","name":"Removal of urethra gland","description":"Excision or fulguration; skenes glands","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22586","name":"Arthrd pre-sac ntrbdy l5-s1","description":"Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, l5-s1 interspace","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1848.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92133","name":"Cptrzd oph dx img pst sgm on","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; optic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58954","name":"Tah rad debulk/lymph remove","description":"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1381.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93282","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3790.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50606","name":"Endoluminal bx urtr rnl plvs","description":"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26555","name":"Positional change of finger","description":"Transfer, finger to another position without microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1155.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27814","name":"Treatment of ankle fracture","description":"Open treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli), includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22595","name":"Arthrd pst tq atlas-axis","description":"Arthrodesis, posterior technique, atlas-axis (c1-c2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1349.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58570","name":"Tlh uterus 250 g or less","description":"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87152","name":"Culture type pulse field gel","description":"Culture, typing; identification by pulse field gel typing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29886","name":"Arthrs knee surg drlg od les","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84210","name":"Assay of pyruvate","description":"Pyruvate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33258","name":"Ablate atria x10sv add-on","description":"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43520","name":"Incision of pyloric muscle","description":"Pyloromyotomy, cutting of pyloric muscle (fredet-ramstedt type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82106","name":"Alpha-fetoprotein amniotic","description":"Alpha-fetoprotein (afp); amniotic fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21386","name":"Opn tx orbit fx periorbital","description":"Open treatment of orbital floor blowout fracture; periorbital approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93290","name":"Interrog dev eval icpms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular physiologic monitor system, including analysis of 1 or more reco","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84143","name":"Assay of 17-hydroxypregneno","description":"17-hydroxypregnenolone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77407","name":"Radiation tx delivery lvl 2","description":"Radiation treatment delivery; level 2, single-isocenter (eg, 3d or imrt), photons, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17274","name":"Dstr mal les s/n/h/f/g 3.1-4","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69706","name":"Nps surg dilat eust tube bi","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2551.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35131","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, iliac artery (common, hypogastric, external)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99474","name":"Self-meas bp 2 readg bid 30d","description":"Self-measured blood pressure using a device validated for clinical accuracy; separate self-measurements of two readings one minute apart, twice daily over a 30-day period (minimum of 12 readings), collection of data reported by the patient and/or caregiver to the physician or other qualified health ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2905.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35522","name":"Art byp grft axill-brachial","description":"Bypass graft, with vein; axillary-brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67414","name":"Explr/decompress eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92260","name":"Ophthalmodynamometry","description":"Ophthalmodynamometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54318","name":"Reconstruction of urethra","description":"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage cecil repair)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82671","name":"Assay of estrogens","description":"Estrogens; fractionated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27220","name":"Treat hip socket fracture","description":"Closed treatment of acetabulum (hip socket) fracture(s); without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90581","name":"Anthrax vaccine sc or im","description":"Anthrax vaccine, for subcutaneous or intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34401","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0064A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97533","name":"Sensory integration","description":"Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61540","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1998.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61140","name":"Burr hole/treph bx brain/les","description":"Burr hole(s) or trephine; with biopsy of brain or intracranial lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92997","name":"Pul art balloon repr percut","description":"Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53500","name":"Urethrlys transvag w/ scope","description":"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91038","name":"Esoph imped funct test > 1hr","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15821","name":"Blepharp lwr eyelid fat pad","description":"Blepharoplasty, lower eyelid; with extensive herniated fat pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92569","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97130","name":"Ther ivntj ea addl 15 min","description":"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38555","name":"Removal neck/armpit lesion","description":"Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78472","name":"Gated heart planar single","description":"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24925","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31257","name":"Nsl/sins ndsc tot w/sphendt","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28226","name":"Release of foot tendons","description":"Tenolysis, extensor, foot; multiple tendons","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97761","name":"Prosthetic traing 1st enc","description":"Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43458","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70373","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21470","name":"Optx complicated mndblr fx","description":"Open treatment of complicated mandibular fracture by multiple surgical approaches including internal fixation, interdental fixation, and/or wiring of dentures or splints","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","name":"Anes thrcm px pulm rescj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82541","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96361","name":"Hydrate iv infusion add-on","description":"Intravenous infusion, hydration; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62303","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95806","name":"Sleep study unatt&resp efft","description":"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43400","name":"Ligate esophagus veins","description":"Ligation, direct, esophageal varices","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1277.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82143","name":"Amniotic fluid scan","description":"Amniotic fluid scan (spectrophotometric)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33690","name":"Banding pulmonary artery","description":"Banding of pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75984","name":"Xray control catheter change","description":"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45400","name":"Laparoscopic proc","description":"Laparoscopy, surgical; proctopexy (for prolapse)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449T","name":"Insj aqueous drain dev 1st","description":"Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; initial device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21125","name":"Augmentation mndblr prostc","description":"Augmentation, mandibular body or angle; prosthetic material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2286.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69650","name":"Stapes mobilization","description":"Stapes mobilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14747.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58770","name":"Create new tubal opening","description":"Salpingostomy (salpingoneostomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42810","name":"Excision of neck cyst","description":"Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99325","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78265","name":"Gstr emptg img sm bwl trnst","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93350","name":"Stress tte only","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21014","name":"Exc face tum deep 2 cm/>","description":"Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60254","name":"Extensive thyroid surgery","description":"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20932","name":"Osteoart algrft w/surf & b1","description":"Allograft, includes templating, cutting, placement and internal fixation, when performed; osteoarticular, including articular surface and contiguous bone (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87632","name":"Resp virus 6-11 targets","description":"Infectious agent detection by nucleic acid (dna or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22843","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76826","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78122","name":"Whl bld volume determination","description":"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75989","name":"Abscess drainage under x-ray","description":"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11901","name":"Inject skin lesions >7","description":"Injection, intralesional; more than 7 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97033","name":"App mdlty 1+iontphrsis ea 15","description":"Application of a modality to 1 or more areas; iontophoresis, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35103","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving iliac vessels (common, hypogastric, external)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60225","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29906","name":"Subtalar arthro w/deb","description":"Arthroscopy, subtalar joint, surgical; with debridement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1017.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KF","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83930","name":"Assay of blood osmolality","description":"Osmolality; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"Pure tone audiometry air","description":"Pure tone audiometry (threshold); air only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"Prev visit new age 18-39","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9978","name":"Remote e/m new pt 10mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a problem focused history; a problem focused examination; and strai","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83527","name":"Assay of insulin","description":"Insulin; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15824","name":"Rhytidectomy forehead","description":"Rhytidectomy; forehead","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2563.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69100","name":"Biopsy of external ear","description":"Biopsy external ear","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62282","name":"Treat spinal canal lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51795","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1314.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43210","name":"Egd esophagogastrc fndoplsty","description":"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0200T","name":"Perq sacral augmt unilat inj","description":"Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, 1 or more needles, includes imaging guidance and bone biopsy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81345","name":"Tert gene targeted seq alys","description":"Tert (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61703","name":"Clamp neck artery","description":"Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (selverstone-crutchfield type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1238.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92588","name":"Evoked auditory tst complete","description":"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74221","name":"X-ray xm esophagus 2cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95978","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95134","name":"Immntx 5 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 5 stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6006","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19303","name":"Mast simple complete","description":"Mastectomy, simple, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65435","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":646.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65140","name":"Attach ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles attached to implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67314","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4860","name":"Disposable catheter tips","description":"Disposable catheter tips for peritoneal dialysis, per 10","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82615","name":"Test for urine cystines","description":"Cystine and homocystine, urine, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"Office o/p est mod 30 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86337","name":"Insulin antibodies","description":"Insulin antibodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71022","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37760","name":"Lig prfratr vn radical 1 leg","description":"Ligation of perforator veins, subfascial, radical (linton type), including skin graft, when performed, open,1 leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43278","name":"Ercp lesion ablate w/dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with ablation of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93620","name":"Comp ep evl r at ven pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":29.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92082","name":"Intermediate visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on goldmann perimeter, or semiquantitative, automated suprathreshold screening program, humphrey suprathreshold automatic diagnostic test, octopus program 33)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84152","name":"Assay of psa complexed","description":"Prostate specific antigen (psa); complexed (direct measurement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33234","name":"Removal of pacemaker system","description":"Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19081","name":"Bx breast 1st lesion strtctc","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including stereotactic guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4911","name":"Drain bag/bottle","description":"Drain bag/bottle, for dialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43200","name":"Esophagoscopy flexible brush","description":"Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90461","name":"Im admin each addl component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11451","name":"Exc skn hdrdnt ax complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","name":"Anes ivntl rad icr icar/aort","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or aortic","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81184","name":"Cacna1a gen detc abnor allel","description":"Cacna1a (calcium voltage-gated channel subunit alpha1 a) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50234","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through same incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","name":"Anes px ear w/bx nos","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9516","name":"Iodine i-123 sod iodide mic","description":"Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75665","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86784","name":"Trichinella antibody","description":"Antibody; trichinella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55720","name":"Drainage of prostate abscess","description":"Prostatotomy, external drainage of prostatic abscess, any approach; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65865","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64708","name":"Revise arm/leg nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93975","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21470","name":"Optx complicated mndblr fx","description":"Open treatment of complicated mandibular fracture by multiple surgical approaches including internal fixation, interdental fixation, and/or wiring of dentures or splints","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27175","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by traction, without reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25270","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each tendon or muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92549","name":"Cdp-sot 6 cond w/i&r mct&adt","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (mct) and adaptation test (adt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0446","name":"Intens behave ther cardio dx","description":"Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20527","name":"Njx nzm palmar fascial cord","description":"Injection, enzyme (eg, collagenase), palmar fascial cord (ie, dupuytrens contracture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35001","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, carotid, subclavian artery, by neck incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28456","name":"Prq skel fix tarsl fx w/mnpj","description":"Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14418.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1373.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","name":"Scr mammo bi incl cad","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59325","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; abdominal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"R0075","name":"Transport port x-ray multipl","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88368","name":"Insitu hybridization manual","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59120","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93793","name":"Anticoag mgmt pt warfarin","description":"Anticoagulant management for a patient taking warfarin, must include review and interpretation of a new home, office, or lab international normalized ratio (inr) test result, patient instructions, dosage adjustment (as needed), and scheduling of additional test(s), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99497","name":"Advncd care plan 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surroga","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17281","name":"Dstr mal ls f/e/e/n/l/m .6-1","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22844","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47381","name":"Open ablate liver tumor cryo","description":"Ablation, open, of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99374","name":"Home health care supervision","description":"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, alzheimers facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67218","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38241","name":"Transplt autol hct/donor","description":"Hematopoietic progenitor cell (hpc); autologous transplantation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78454","name":"Ht musc image planar mult","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49900","name":"Repair of abdominal wall","description":"Suture, secondary, of abdominal wall for evisceration or dehiscence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78832","name":"Rp loclzj tum spect w/ct 2","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51727","name":"Cystometrogram w/up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43865","name":"Revj gstr/jj anast w/vgtmy","description":"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75635","name":"Ct angio abdominal arteries","description":"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","name":"Anes px art knee&pop exc&grf","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73721","name":"Mri jnt of lwr extre w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4126.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63650","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array, epidural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36248","name":"Ins cath abd/l-ext art addl","description":"Selective catheter placement, arterial system; additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (list in addition to code for initial second or third order vessel as appropriate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP21","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44314","name":"Revision of ileostomy","description":"Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58321","name":"Artificial insemination","description":"Artificial insemination; intra-cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87810","name":"Chlmyd trach assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; chlamydia trachomatis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27871","name":"Fusion of tibiofibular joint","description":"Arthrodesis, tibiofibular joint, proximal or distal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8584.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33984","name":"Ecmo/ecls rmvl prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, 6 years and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25650","name":"Cltx ulnar styloid fracture","description":"Closed treatment of ulnar styloid fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68840","name":"Explore/irrigate tear ducts","description":"Probing of lacrimal canaliculi, with or without irrigation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3674.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29873","name":"Arthrs knee surg w/lat rls","description":"Arthroscopy, knee, surgical; with lateral release","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1565.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28220","name":"Release of foot tendon","description":"Tenolysis, flexor, foot; single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":595.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50947","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87622","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31529","name":"Laryngoscopy and dilation","description":"Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99364","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82651","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78835","name":"Rp quan meas single area","description":"Radiopharmaceutical quantification measurement(s) single area (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33425","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2378.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43327","name":"Esoph fundoplasty lap","description":"Esophagogastric fundoplasty partial or complete; laparotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53850","name":"Prostatic microwave thermotx","description":"Transurethral destruction of prostate tissue; by microwave thermotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82672","name":"Assay of estrogen","description":"Estrogens; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67030","name":"Incise inner eye strands","description":"Discission of vitreous strands (without removal), pars plana approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44210","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1423.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95950","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9500","name":"Tc99m sestamibi","description":"Technetium tc-99m sestamibi, diagnostic, per study dose","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21485","name":"Cltx tmprmand dislc comp","description":"Closed treatment of temporomandibular dislocation; complicated (eg, recurrent requiring intermaxillary fixation or splinting), initial or subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75722","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84449","name":"Assay of transcortin","description":"Transcortin (cortisol binding globulin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19306","name":"Mast rad urban type","description":"Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph nodes (urban type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92370","name":"Rpr&refitg spect xcp aphakia","description":"Repair and refitting spectacles; except for aphakia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47544","name":"Removal duct glbldr calculi","description":"Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation (list sep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24101","name":"Arthrt elbw jt expl bx rmvl","description":"Arthrotomy, elbow; with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99463","name":"Same day nb discharge","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and discharged on the same date","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","name":"Anes integ sys rcnstv breast","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7608.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43244","name":"Egd varices ligation","description":"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55801","name":"Removal of prostate","description":"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4102","name":"Ef adult fluids and electro","description":"Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27198","name":"Clsd tx pelvic ring fx","description":"Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; with ma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95970","name":"Alys npgt w/o prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33230","name":"Insrt pulse gen w/dual leads","description":"Insertion of implantable defibrillator pulse generator only; with existing dual leads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93528","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38505","name":"Needle biopsy lymph nodes","description":"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42842","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59001","name":"Amniocentesis therapeutic","description":"Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L5311","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1665.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82946","name":"Glucagon tolerance test","description":"Glucagon tolerance test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1825","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92575","name":"Sensorineural acuity lvl tst","description":"Sensorineural acuity level test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61610","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93750","name":"Interrogation vad in person","description":"Interrogation of ventricular assist device (vad), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of device function (eg, flow and volume status, septum status, recovery), with programming, if performe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51570","name":"Removal of bladder","description":"Cystectomy, complete; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82390","name":"Assay of ceruloplasmin","description":"Ceruloplasmin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75572","name":"Ct hrt w/3d image","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77021","name":"Mri guidance ndl plmt rs&i","description":"Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49505","name":"Prp i/hern init reduc >5 yr","description":"Repair initial inguinal hernia, age 5 years or older; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33755","name":"Shunt as-aort to pulm art","description":"Shunt; ascending aorta to pulmonary artery (waterston type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1140.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43361","name":"Gastrointestinal repair","description":"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86590","name":"Streptokinase antibody","description":"Streptokinase, antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9555","name":"Rb82 rubidium","description":"Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76377","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84138","name":"Assay of pregnanetriol","description":"Pregnanetriol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84206","name":"Assay of proinsulin","description":"Proinsulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96040","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27750","name":"Treatment of tibia fracture","description":"Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84481","name":"Free assay (ft-3)","description":"Triiodothyronine t3; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78272","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0247T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KL","NU"]},{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0217T","name":"Njx paravert w/us lumb/sac","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96154","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50394","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23077","name":"Rad rescj tum shoulder<5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10007","name":"Fna bx w/fluor gdn 1st les","description":"Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2530.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23520","name":"Cltx strnclav dislc w/o mnpj","description":"Closed treatment of sternoclavicular dislocation; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26551","name":"Great toe-hand transfer","description":"Transfer, toe-to-hand with microvascular anastomosis; great toe wrap-around with bone graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2790.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43350","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93922","name":"Upr/l xtremity art 2 levels","description":"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waveform recording and analysis at 1-2 levels, or ankle/brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63303","name":"Remov vert xdrl bdy lmbr/sac","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41145","name":"Tongue removal neck surgery","description":"Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2140.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86696","name":"Herpes simplex type 2 test","description":"Antibody; herpes simplex, type 2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","name":"Anes opn/arthr tot sho rplcm","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28576","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87798","name":"Detect agent nos dna amp","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; amplified probe technique, each organism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86344","name":"Leukocyte phagocytosis","description":"Leukocyte phagocytosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78594","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22900","name":"Exc abdl tum deep < 5 cm","description":"Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8185","name":"Flutter device","description":"Flutter device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96001","name":"Motion test w/ft press meas","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics; with dynamic plantar pressure measurements during walking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99380","name":"Nursing fac care supervision","description":"Supervision of a nursing facility patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, comm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49062","name":"Drain to peritoneal cavity","description":"Drainage of extraperitoneal lymphocele to peritoneal cavity, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88164","name":"Cytopath tbs c/v manual","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); manual screening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34820","name":"Opn iliac art expos","description":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19324","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4607.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27358","name":"Remove femur lesion/fixation","description":"Excision or curettage of bone cyst or benign tumor of femur; with internal fixation (list in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37229","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97162","name":"Pt eval mod complex 30 min","description":"Physical therapy evaluation: moderate complexity, requiring these components: a history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; an examination of body systems using standardized tests and measures in addressing a total of 3 or more elements fro","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2335.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2536.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"Home/res vst new low mdm 30","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0165T","name":"Revise lumb artif disc addl","description":"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23505","name":"Cltx clavicular fx w/mnpj","description":"Closed treatment of clavicular fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65091","name":"Revise eye","description":"Evisceration of ocular contents; without implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31368","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, with radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1946.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63082","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2067.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62225","name":"Replace/irrigate catheter","description":"Replacement or irrigation, ventricular catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74270","name":"X-ray xm colon 1cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43632","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastrojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62192","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0452","name":"Molecular pathology interpr","description":"Molecular pathology procedure; physician interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87522","name":"Hepatitis c revrs trnscrpj","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, quantification, includes reverse transcription when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33755","name":"Shunt as-aort to pulm art","description":"Shunt; ascending aorta to pulmonary artery (waterston type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1140.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"Venipuncture cutdown < 1 yr","description":"Venipuncture, cutdown; younger than age 1 year","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45335","name":"Sigmoidoscopy w/submuc inj","description":"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27840","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87107","name":"Fungi identification mold","description":"Culture, fungi, definitive identification, each organism; mold","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95251","name":"Cont gluc mntr analysis i&r","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KM","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81184","name":"Cacna1a gen detc abnor allel","description":"Cacna1a (calcium voltage-gated channel subunit alpha1 a) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27620","name":"Explore/treat ankle joint","description":"Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27698","name":"Repair of ankle ligament","description":"Repair, secondary, disrupted ligament, ankle, collateral (eg, watson-jones procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8387.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21433","name":"Optx cranfcl sep comp mlt","description":"Open treatment of craniofacial separation (lefort iii type); complicated (eg, comminuted or involving cranial nerve foramina), multiple surgical approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2810.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23660","name":"Optx acute shoulder dislc","description":"Open treatment of acute shoulder dislocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4102","name":"Ef adult fluids and electro","description":"Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91055","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65757","name":"Prep corneal endo allograft","description":"Backbench preparation of corneal endothelial allograft prior to transplantation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50722","name":"Release of ureter","description":"Ureterolysis for ovarian vein syndrome","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","name":"Anes cardiac catheterization","description":"Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include swan-ganz catheter)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17284","name":"Dstr mal ls f/e/e/n/l/m3.1-4","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP09","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":492.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53448","name":"Remov/replc ur sphinctr comp","description":"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement of infected tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7260","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":976.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64872","name":"Subsequent repair of nerve","description":"Suture of nerve; requiring secondary or delayed suture (list separately in addition to code for primary neurorrhaphy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27100","name":"Transfer of abdominal muscle","description":"Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0246","name":"Followup eval of foot pt lop","description":"Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65101","name":"Removal of eye","description":"Enucleation of eye; without implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77418","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21600","name":"Partial removal of rib","description":"Excision of rib, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19564.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88305","name":"Tissue exam by pathologist","description":"Level iv - surgical pathology, gross and microscopic examination abortion - spontaneous/missed artery, biopsy bone marrow, biopsy bone exostosis brain/meninges, other than for tumor resection breast, biopsy, not requiring microscopic evaluation of surgical margins breast, reduction mammoplasty bronc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74022","name":"Radex compl aqt abd series","description":"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87641","name":"Mr-staph dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); staphylococcus aureus, methicillin resistant, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58544","name":"Lsh w/t/o uterus above 250 g","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46715","name":"Rep perf anoper fistu","description":"Repair of low imperforate anus; with anoperineal fistula (cut-back procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61215","name":"Ins subq rsvr pmp/nfs sys","description":"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78433","name":"Myocrd img pet 2rtracer ct","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2170.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3331.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54326","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27290","name":"Amputation of leg at hip","description":"Interpelviabdominal amputation (hindquarter amputation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99334","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95990","name":"Spin/brain pump refil & main","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99315","name":"Nf dschrg mgmt 30 min/less","description":"Nursing facility discharge management; 30 minutes or less total time on the date of the encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41805","name":"Removal foreign body gum","description":"Removal of embedded foreign body from dentoalveolar structures; soft tissues","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43314","name":"Tracheo-esophagoplasty cong","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; with repair of congenital tracheoesophageal fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2445.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27840","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63286","name":"Bx/exc idrl imed lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84480","name":"Assay triiodothyronine (t3)","description":"Triiodothyronine t3; total (tt-3)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21920","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99453","name":"Rem mntr physiol param setup","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); initial set-up and patient education on use of equipment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2301","name":"Pwr standing","description":"Wheelchair accessory, power standing system, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22857","name":"Tot disc arthrp 1ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); single interspace, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","name":"Anes rad amp pns ingun&ilac","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86360","name":"T cell absolute count/ratio","description":"T cells; absolute cd4 and cd8 count, including ratio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9141","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77003","name":"Fluoroguide for spine inject","description":"Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60200","name":"Remove thyroid lesion","description":"Excision of cyst or adenoma of thyroid, or transection of isthmus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"Esrd svc pr day pt 2-11","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 2-11 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20922","name":"Removal of fascia for graft","description":"Fascia lata graft; by incision and area exposure, complex or sheet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15421","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22552","name":"Arthrd ant ntrbd cervical ea","description":"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below c2, each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93312","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35509","name":"Art byp grft contral carotid","description":"Bypass graft, with vein; carotid-contralateral carotid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59100","name":"Remove uterus lesion","description":"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11901","name":"Inject skin lesions >7","description":"Injection, intralesional; more than 7 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82482","name":"Assay rbc cholinesterase","description":"Cholinesterase; rbc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3222","name":"Mens shoes hightop depth inl","description":"Orthopedic footwear, mens shoe, hightop, depth inlay, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6239","name":"Hydrocolld drg > 48 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82379","name":"Assay of carnitine","description":"Carnitine (total and free), quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63272","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78835","name":"Rp quan meas single area","description":"Radiopharmaceutical quantification measurement(s) single area (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64643","name":"Chemodenerv 1 extrem 1-4 ea","description":"Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26352","name":"Repair/graft hand tendon","description":"Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no mans land); secondary with free graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61863","name":"Implant neuroelectrode","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; first array","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60600","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; without excision of carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1185.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21116","name":"Injection jaw joint x-ray","description":"Injection procedure for temporomandibular joint arthrography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32310","name":"Removal of chest lining","description":"Pleurectomy, parietal (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94727","name":"Gas dil/wshot deter lng vol","description":"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27442","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58301","name":"Remove intrauterine device","description":"Removal of intrauterine device (iud)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15003","name":"Wound prep addl 100 cm","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74240","name":"X-ray xm upr gi trc 1cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28234","name":"Incision of foot tendon","description":"Tenotomy, open, extensor, foot or toe, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60260","name":"Repeat thyroid surgery","description":"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43830","name":"Gstrst open wo constj tube","description":"Gastrostomy, open; without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82595","name":"Assay of cryoglobulin","description":"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74270","name":"X-ray xm colon 1cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44208","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1603.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33416","name":"Revise ventricle muscle","description":"Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis (eg, asymmetric septal hypertrophy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1755.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77771","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32820","name":"Reconstruct injured chest","description":"Major reconstruction, chest wall (posttraumatic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63190","name":"Incise spine nrv >2 segmnts","description":"Laminectomy with rhizotomy; more than 2 segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31570","name":"Laryngoscope w/vc inj","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58294","name":"Vag hyst w/enterocele compl","description":"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70481","name":"Ct orbit/ear/fossa w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59410","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23200","name":"Radical rescj tumor clavicle","description":"Radical resection of tumor; clavicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63043","name":"Laminotomy addl cervical","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional cervical interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85055","name":"Reticulated platelet assay","description":"Reticulated platelet assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83950","name":"Oncoprotein her-2/neu","description":"Oncoprotein; her-2/neu","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0555","name":"Humidifier for use w/ regula","description":"Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33949","name":"Ecmo/ecls daily mgmt artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; daily management, each day, veno-arterial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64450","name":"Njx aa&/strd other pn/branch","description":"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92140","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73225","name":"Mr angio upr extr w/o&w/dye","description":"Magnetic resonance angiography, upper extremity, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22843","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45331","name":"Sigmoidoscopy and biopsy","description":"Sigmoidoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33519","name":"Cabg artery-vein three","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 3 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29876","name":"Arthrs knee surg synvct maj","description":"Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27397","name":"Transplants of thigh tendons","description":"Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); multiple tendons","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33995","name":"Insj perq vad r hrt venous","description":"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; right heart, venous access only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66172","name":"Incision of eye","description":"Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":859.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85300","name":"Antithrombin iii activity","description":"Clotting inhibitors or anticoagulants; antithrombin iii, activity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32098","name":"Open biopsy of lung pleura","description":"Thoracotomy, with biopsy(ies) of pleura","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31360","name":"Removal of larynx","description":"Laryngectomy; total, without radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1556.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33363","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open axillary artery approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0001","name":"Alcohol and/or drug assess","description":"Alcohol and/or drug assessment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4100","name":"Food thickener oral","description":"Food thickener, administered orally, per ounce","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32856","name":"Prepare donor lung double","description":"Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0243","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15833","name":"Exc excessive skin leg","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49420","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63190","name":"Incise spine nrv >2 segmnts","description":"Laminectomy with rhizotomy; more than 2 segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3342.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21110","name":"Interdental fixation","description":"Application of interdental fixation device for conditions other than fracture or dislocation, includes removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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 ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95075","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1383.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16000","name":"Initial treatment of burn(s)","description":"Initial treatment, first degree burn, when no more than local treatment is required","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99225","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33814","name":"Obltrj a-pulm sep def w/byp","description":"Obliteration of aortopulmonary septal defect, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1320.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75662","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37616","name":"Ligation major artery chest","description":"Ligation, major artery (eg, post-traumatic, rupture); chest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25275","name":"Repair forearm tendon sheath","description":"Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor carpi ulnaris subluxation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1720.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75989","name":"Abscess drainage under x-ray","description":"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90658","name":"Iiv3 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4268","name":"Female condom","description":"Contraceptive supply, condom, female, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28415","name":"Optx calcaneal fracture","description":"Open treatment of calcaneal fracture, includes internal fixation, when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47711","name":"Excision of bile duct tumor","description":"Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21242","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1769","name":"Guide wire","description":"Guide wire","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43274","name":"Ercp duct stent placement","description":"Endoscopic retrograde cholangiopancreatography (ercp); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67400","name":"Explore/biopsy eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8270","name":"Enuresis alarm","description":"Enuresis alarm, using auditory buzzer and/or vibration device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50320","name":"Remove kidney living donor","description":"Donor nephrectomy (including cold preservation); open, from living donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32658","name":"Thoracoscopy w/sac fb remove","description":"Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63003","name":"Remove spine lamina 1/2 thrc","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82108","name":"Assay of aluminum","description":"Aluminum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33470","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44147","name":"Partial removal of colon","description":"Colectomy, partial; abdominal and transanal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1601.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33720","name":"Repair of heart defect","description":"Repair sinus of valsalva aneurysm, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01430","name":"Anes px veins knee&pop nos","description":"Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22853","name":"Insj biomechanical device","description":"Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (list separately in addition to code fo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95971","name":"Alys smpl sp/pn npgt w/prgrm","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"Prev visit new age 12-17","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46705","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21360","name":"Opn tx dprsd malar fracture","description":"Open treatment of depressed malar fracture, including zygomatic arch and malar tripod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87252","name":"Virus inoculation tissue","description":"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9502","name":"Tc99m tetrofosmin","description":"Technetium tc-99m tetrofosmin, diagnostic, per study dose","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57300","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; vaginal or transanal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15572","name":"Skin pedicle flap arms/legs","description":"Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1976.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4519.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36818","name":"Av fuse uppr arm cephalic","description":"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2007","name":"Post-d/c h vst ext pt 30 m","description":"Limited (30 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient faci","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84119","name":"Test urine for porphyrins","description":"Porphyrins, urine; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86331","name":"Immunodiffusion ouchterlony","description":"Immunodiffusion; gel diffusion, qualitative (ouchterlony), each antigen or antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83835","name":"Assay of metanephrines","description":"Metanephrines","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92353","name":"Fit aphakia spectcl multifoc","description":"Fitting of spectacle prosthesis for aphakia; multifocal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27752","name":"Treatment of tibia fracture","description":"Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36589","name":"Removal tunneled cv cath","description":"Removal of tunneled central venous catheter, without subcutaneous port or pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35685","name":"Bypass graft patency/patch","description":"Placement of vein patch or cuff at distal anastomosis of bypass graft, synthetic conduit (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58290","name":"Vag hyst complex","description":"Vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90935","name":"Hemodialysis one evaluation","description":"Hemodialysis procedure with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440T","name":"Abltj perc uxtr/perph nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47505","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3727.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99245","name":"Off/op consltj new/est hi 55","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8685","name":"Implt nrostm pls gen sng rec","description":"Implantable neurostimulator pulse generator, single array, rechargeable, includes extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6369.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73223","name":"Mri joint upr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86328","name":"Ia nfct ab sarscov2 covid19","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1860.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63005","name":"Remove spine lamina 1/2 lmbr","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except for spondylolisthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27307","name":"Incision of thigh tendons","description":"Tenotomy, percutaneous, adductor or hamstring; multiple tendons","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69150","name":"Extensive ear canal surgery","description":"Radical excision external auditory canal lesion; without neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88120","name":"Cytp urne 3-5 probes ea spec","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44310","name":"Ileostomy/jejunostomy","description":"Ileostomy or jejunostomy, non-tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","name":"Anes nrv msc upr a&e tndsis","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22855","name":"Removal anterior instrmj","description":"Removal of anterior instrumentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":982.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3512.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35612","name":"Bpg subclavian-subclavian","description":"Bypass graft, with other than vein; subclavian-subclavian","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3255","name":"Orth foot non-standard size/","description":"Non-standard size or length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47383","name":"Perq abltj lvr cryoablation","description":"Ablation, 1 or more liver tumor(s), percutaneous, cryoablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","QB","NU","QF","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4564.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84577","name":"Assay of feces/urobilinogen","description":"Urobilinogen, feces, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0515","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4104","name":"Additive for enteral formula","description":"Additive for enteral formula (e.g., fiber)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42890","name":"Limited pharyngectomy","description":"Limited pharyngectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71021","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37232","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27532","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); with or without manipulation, with skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88361","name":"Tumor immunohistochem/comput","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72081","name":"X-ray exam entire spi 1 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95874","name":"Guide nerv destr needle emg","description":"Needle electromyography for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87206","name":"Smear fluorescent/acid stai","description":"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33369","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81186","name":"Cacna1a gen known famil vrnt","description":"Cacna1a (calcium voltage-gated channel subunit alpha1 a) (eg, spinocerebellar ataxia) gene analysis; known familial variant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30200","name":"Injection treatment of nose","description":"Injection into turbinate(s), therapeutic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5241","name":"Dispensing fee, monaural","description":"Dispensing fee, monaural hearing aid, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28705","name":"Arthrodesis pantalar","description":"Arthrodesis; pantalar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5646.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37606","name":"Lig int/com carotid art occl","description":"Ligation; internal or common carotid artery, with gradual occlusion, as with selverstone or crutchfield clamp","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85420","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66940","name":"Extraction of lens","description":"Removal of lens material; extracapsular (other than 66840, 66850, 66852)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21242","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86309","name":"Heterophile antibody titer","description":"Heterophile antibodies; titer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","name":"Anes all px nrv msc kne&/pop","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61626","name":"Tcat perm occls/embol noncns","description":"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention, percutaneous,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58291","name":"Vag hyst incl t/o complex","description":"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88263","name":"Chromosome analysis 45","description":"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46712","name":"Repr per/vag pouch dbl proc","description":"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; combined transperineal and transabdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51720","name":"Treatment of bladder lesion","description":"Bladder instillation of anticarcinogenic agent (including retention time)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38101","name":"Removal of spleen partial","description":"Splenectomy; partial (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31638","name":"Bronchoscopy revise stent","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with revision of tracheal or bronchial stent inserted at previous session (includes tracheal/bronchial dilation as required)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27598","name":"Amputate lower leg at knee","description":"Disarticulation at knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74246","name":"X-ray xm upr gi trc 2cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2634.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93609","name":"Intra-vntr mapg tchycar site","description":"Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6967.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37788","name":"Revascularization penis","description":"Penile revascularization, artery, with or without vein graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35875","name":"Removal of clot in graft","description":"Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41108","name":"Biopsy of floor of mouth","description":"Biopsy of floor of mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82946","name":"Glucagon tolerance test","description":"Glucagon tolerance test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21180","name":"Rcnstj forehead w/autograft","description":"Reconstruction, entire or majority of forehead and/or supraorbital rims; with autograft (includes obtaining grafts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24516","name":"Tx humrl shaft fx imed implt","description":"Treatment of humeral shaft fracture, with insertion of intramedullary implant, with or without cerclage and/or locking screws","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35570","name":"Art byp tibial-tib/peroneal","description":"Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93279","name":"Prgrmg dev eval pm/ldls pm","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system or","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11646","name":"Exc f/e/e/n/l mal+mrg >4 cm","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49427","name":"Injection abdominal shunt","description":"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36904","name":"Thrmbc/nfs dialysis circuit","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thromboly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34520","name":"Cross-over vein graft","description":"Cross-over vein graft to venous system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27049","name":"Resect hip/pelv tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24586","name":"Optx partclr fx&/dislc elbow","description":"Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24370","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28230","name":"Incision of foot tendon(s)","description":"Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83630","name":"Lactoferrin fecal (qual)","description":"Lactoferrin, fecal; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0076","name":"Care manag h vst new pt 20 m","description":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84138","name":"Assay of pregnanetriol","description":"Pregnanetriol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3942.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24515","name":"Optx humrl shft fx plate/scr","description":"Open treatment of humeral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86490","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64489","name":"Tap block bi by infusion","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86361","name":"T cell absolute count","description":"T cells; absolute cd4 count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21270","name":"Augmentation cheek bone","description":"Malar augmentation, prosthetic material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23920","name":"Disarticulation shoulder","description":"Disarticulation of shoulder;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26860","name":"Fusion of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64802","name":"Sympathectomy cervical","description":"Sympathectomy, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57250","name":"Repair rectum & vagina","description":"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11103","name":"Tangntl bx skin ea sep/addl","description":"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); each separate/additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97760","name":"Orthotic mgmt&traing 1st enc","description":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42950","name":"Reconstruction of throat","description":"Pharyngoplasty (plastic or reconstructive operation on pharynx)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61156","name":"Burr hol aspir hmtm/cst icer","description":"Burr hole(s); with aspiration of hematoma or cyst, intracerebral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43496","name":"Free jejunum flap microvasc","description":"Free jejunum transfer with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1071.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43254","name":"Egd endo mucosal resection","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4467.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40844","name":"Reconstruction of mouth","description":"Vestibuloplasty; entire arch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1182.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86215","name":"Deoxyribonuclease antibody","description":"Deoxyribonuclease, antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38500","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75563","name":"Card mri w/stress img & dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25505","name":"Cltx rdl shft fx w/mnpj","description":"Closed treatment of radial shaft fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55175","name":"Revision of scrotum","description":"Scrotoplasty; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10004","name":"Fna bx w/o img gdn ea addl","description":"Fine needle aspiration biopsy, without imaging guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95950","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1840.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1293.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51715","name":"Endoscopic injection/implant","description":"Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82378","name":"Carcinoembryonic antigen","description":"Carcinoembryonic antigen (cea)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58291","name":"Vag hyst incl t/o complex","description":"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43243","name":"Egd injection varices","description":"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","name":"Anes opn/arthrs knee jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28173","name":"Resect metatarsal tumor","description":"Radical resection of tumor; metatarsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6086.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77767","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34051","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33030","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1736.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63306","name":"Remov vert idrl bdy thrclmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522T","name":"Prgrmg dev eval wcs ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78453","name":"Ht muscle image planar sing","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37227","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7249.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54336","name":"Revise penis/urethra","description":"1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37236","name":"Open/perq place stent 1st","description":"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44389","name":"Colonoscopy with biopsy","description":"Colonoscopy through stoma; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99190","name":"Special pump services","description":"Assembly and operation of pump with oxygenator or heat exchanger (with or without ecg and/or pressure monitoring); each hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27659","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92575","name":"Sensorineural acuity lvl tst","description":"Sensorineural acuity level test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89105","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44143","name":"Partial removal of colon","description":"Colectomy, partial; with end colostomy and closure of distal segment (hartmann type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93539","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63047","name":"Lam facetec & foramot lumbar","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0368","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49423","name":"Exchange drainage catheter","description":"Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15756","name":"Free myo/skin flap microvasc","description":"Free muscle or myocutaneous flap with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1458.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","name":"Anes thrc spine wo 1lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26670","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52353","name":"Cystouretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73720","name":"Mri lwr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40500","name":"Partial excision of lip","description":"Vermilionectomy (lip shave), with mucosal advancement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21014","name":"Exc face tum deep 2 cm/>","description":"Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5536.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19325","name":"Breast augmentation w/implt","description":"Breast augmentation with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17276","name":"Dstr mal les s/n/h/f/g >4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64569","name":"Revise/repl vagus n eltrd","description":"Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76885","name":"Us exam infant hips dynamic","description":"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64783","name":"Limb nerve surgery add-on","description":"Excision of neuroma; hand or foot, each additional nerve, except same digit (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":295.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87281","name":"Pneumocystis carinii ag if","description":"Infectious agent antigen detection by immunofluorescent technique; pneumocystis carinii","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96164","name":"Hlth bhv ivntj grp 1st 30","description":"Health behavior intervention, group (2 or more patients), face-to-face; initial 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4931","name":"Reusable oral thermometer","description":"Oral thermometer, reusable, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3672","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53661","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92326","name":"Replacement of contact lens","description":"Replacement of contact lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53855","name":"Insert prost urethral stent","description":"Insertion of a temporary prostatic urethral stent, including urethral measurement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83518","name":"Immunoassay dipstick","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78481","name":"Heart first pass single","description":"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93986","name":"Dup-scan hemo compl uni std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71555","name":"Mri angio chest w or w/o dye","description":"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58150","name":"Total hysterectomy","description":"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":0.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69660","name":"Revise middle ear bone","description":"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42408","name":"Excision of salivary cyst","description":"Excision of sublingual salivary cyst (ranula)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1457.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1545.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46716","name":"Rep perf anoper/vestib fistu","description":"Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20974","name":"Estim aid bone healg n-invas","description":"Electrical stimulation to aid bone healing; noninvasive (nonoperative)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3438.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31536","name":"Laryngoscopy w/bx & op scope","description":"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87501","name":"Influenza dna amp prob 1+","description":"Infectious agent detection by nucleic acid (dna or rna); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61253","name":"Burr hole treph ittl uni/bi","description":"Burr hole(s) or trephine, infratentorial, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66770","name":"Removal of inner eye lesion","description":"Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2903.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25001","name":"Incise flexor carpi radialis","description":"Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1037.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64732","name":"Incision of brow nerve","description":"Transection or avulsion of; supraorbital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3676.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23044","name":"Arthrt ac sc jt exp/rmvl fb","description":"Arthrotomy, acromioclavicular, sternoclavicular joint, including exploration, drainage, or removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92522","name":"Evaluate speech production","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15839","name":"Exc excessive skn other area","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552T","name":"Low-level laser therapy","description":"Low-level laser therapy, dynamic photonic and dynamic thermokinetic energies, provided by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36575","name":"Repair tunneled cv cath","description":"Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23395","name":"Muscle transfer shoulder/arm","description":"Muscle transfer, any type, shoulder or upper arm; single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4765","name":"Dialysate conc pow per pack","description":"Dialysate concentrate, powder, additive for peritoneal dialysis, per packet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":15.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69820","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74246","name":"X-ray xm upr gi trc 2cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98928","name":"Osteopath manj 7-8 regions","description":"Osteopathic manipulative treatment (omt); 7-8 body regions involved","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","name":"Anes gastrocnemius recession","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92577","name":"Stenger test speech","description":"Stenger test, speech","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24301","name":"Musc/tdn transfer upr a/e 1","description":"Muscle or tendon transfer, any type, upper arm or elbow, single (excluding 24320-24331)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52235","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27197","name":"Clsd tx pelvic ring fx","description":"Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; without","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88112","name":"Cytopath cell enhance tech","description":"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23333","name":"Remove shoulder fb deep","description":"Removal of foreign body, shoulder; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30903","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95938","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96121","name":"Nubhvl xm phy/qhp ea addl hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84439","name":"Assay of free thyroxine","description":"Thyroxine; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33886","name":"Delayed plmt dstl xtn prosth","description":"Delayed placement of distal extension prosthesis(es) from the level of the left subclavian artery to the celiac artery, after endovascular repair of descending thoracic aorta, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological superv","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4627","name":"Spacer bag/reservoir","description":"Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61556","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; frontal or parietal bone flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1560.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","name":"Anes thrc spine w/1 lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2531.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32608","name":"Thoracoscopy w/bx nodule","description":"Thoracoscopy; with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3003.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KC","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42260","name":"Repair nose to lip fistula","description":"Repair of nasolabial fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24900","name":"Amputation of upper arm","description":"Amputation, arm through humerus; with primary closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98941","name":"Chiropract manj 3-4 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 3-4 regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33249","name":"Insj/rplcmt defib w/lead(s)","description":"Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67810","name":"Incal bx eyelid skn lid mrgn","description":"Incisional biopsy of eyelid skin including lid margin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29804","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, surgical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82760","name":"Assay of galactose","description":"Galactose","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4485.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51610","name":"Injection for bladder x-ray","description":"Injection procedure for retrograde urethrocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32668","name":"Thoracoscopy w/w resect diag","description":"Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28001","name":"Drainage of bursa of foot","description":"Incision and drainage, bursa, foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28665","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7077.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31200","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, anterior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54100","name":"Biopsy of penis","description":"Biopsy of penis; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52356","name":"Cysto/uretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, gibbons or double-j type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69915","name":"Incise inner ear nerve","description":"Vestibular nerve section, translabyrinthine approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1228.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":835.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38780","name":"Remove abdomen lymph nodes","description":"Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4657.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26476","name":"Tendon lengthening","description":"Lengthening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21386","name":"Opn tx orbit fx periorbital","description":"Open treatment of orbital floor blowout fracture; periorbital approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63012","name":"Remove lamina/facets lumbar","description":"Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (gill type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58545","name":"Laparoscopic myomectomy","description":"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29435","name":"Appl patllr tdn bearing cast","description":"Application of patellar tendon bearing (ptb) cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36832","name":"Av fistula revision open","description":"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0214T","name":"Njx paravert w/us cer/thor","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72084","name":"X-ray exam entire spi 6/> vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92626","name":"Eval aud funcj 1st hour","description":"Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); first hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"Office o/p new low 30 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69554","name":"Exc aurl glomus tum extended","description":"Excision aural glomus tumor; extended (extratemporal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2034.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72159","name":"Mr angio spine w/o&w/dye","description":"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14060","name":"Tis trnfr e/n/e/l 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92083","name":"Extended visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, hump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21743","name":"Repair sternum/nuss w/scope","description":"Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (nuss procedure), with thoracoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43206","name":"Esoph optical endomicroscopy","description":"Esophagoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31656","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C1300","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47400","name":"Incision of liver duct","description":"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1810.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420T","name":"Dstrj neurofibroma xtnsv","description":"Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); trunk and extremities, extensive, greater than 100 neurofibromas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99420","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0396","name":"Alcohol/subs interv 15-30mn","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1464.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":772.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24151","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":839.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38220","name":"Dx bone marrow aspirations","description":"Diagnostic bone marrow; aspiration(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0399","name":"Home sleep test/type 3 porta","description":"Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44346","name":"Revision of colostomy","description":"Revision of colostomy; with repair of paracolostomy hernia (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23605","name":"Cltx prx hmrl fx mnpj+-tract","description":"Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation, with or without skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0451","name":"Devlopment test interpt&rep","description":"Development testing, with interpretation and report, per standardized instrument form","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32666","name":"Thoracoscopy w/wedge resect","description":"Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50236","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through separate incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1185.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12005","name":"Rpr s/n/a/gen/trk12.6-20.0cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33675","name":"Close mult vsd","description":"Closure of multiple ventricular septal defects;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1715.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90935","name":"Hemodialysis one evaluation","description":"Hemodialysis procedure with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77421","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24073","name":"Ex arm/elbow tum deep 5 cm/>","description":"Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93228","name":"Remote 30 day ecg rev/report","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86140","name":"C-reactive protein","description":"C-reactive protein;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21193","name":"Reconst lwr jaw w/o graft","description":"Reconstruction of mandibular rami, horizontal, vertical, c, or l osteotomy; without bone graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":993.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81020","name":"Urinalysis glass test","description":"Urinalysis; 2 or 3 glass test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97607","name":"Neg prs wnd thr ndme<=50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46211","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45315","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33619","name":"Repair single ventricle","description":"Repair of single ventricle with aortic outflow obstruction and aortic arch hypoplasia (hypoplastic left heart syndrome) (eg, norwood procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1809.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75573","name":"Ct hrt c+ strux cgen hrt ds","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3d image postprocessing, assessment of left ventricular [lv] cardiac function, right ventricular [rv] structure and function and evaluation of ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85732","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); substitution, plasma fractions, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","name":"Anes all px neck nos 1yr/>","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83907","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3141.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60270","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65410","name":"Biopsy of cornea","description":"Biopsy of cornea","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31525","name":"Dx laryngoscopy excl nb","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35472","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1484.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8329.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","name":"Anes xtrprt lwr abd prst8ect","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9979","name":"Remote e/m new pt 20mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: an expanded problem focused history; an expanded problem focused ex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93015","name":"Cv stress test supvj i&r","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30540","name":"Rpr choanal atresia ntranasl","description":"Repair choanal atresia; intranasal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77001","name":"Fluoroguide for vein device","description":"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic su","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58611","name":"Ligate oviduct(s) add-on","description":"Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64821","name":"Sympathectomy radial artery","description":"Sympathectomy; radial artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22207","name":"Incis spine 3 column lumbar","description":"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2107.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78465","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1758","name":"Catheter, ureteral","description":"Catheter, ureteral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93792","name":"Pt/caregiver traing home inr","description":"Patient/caregiver training for initiation of home international normalized ratio (inr) monitoring under the direction of a physician or other qualified health care professional, face-to-face, including use and care of the inr monitor, obtaining blood sample, instructions for reporting home inr test ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11022.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49653","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50433","name":"Plmt nephroureteral catheter","description":"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88388","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]},{"negotiated_type":"negotiated","negotiated_rate":1364.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73219","name":"Mri upper extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64614","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81284","name":"Fxn gene detc abnor alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1281.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0076T","name":"S&i stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":107.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27403","name":"Repair of knee cartilage","description":"Arthrotomy with meniscus repair, knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43279","name":"Lap myotomy heller","description":"Laparoscopy, surgical, esophagomyotomy (heller type), with fundoplasty, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58550","name":"Laparo-asst vag hysterectomy","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","name":"Anes px nrv musc upr a&e nos","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72133","name":"Ct lumbar spine w/o & w/dye","description":"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83009","name":"H pylori (c-13) blood","description":"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65772","name":"Correction of astigmatism","description":"Corneal relaxing incision for correction of surgically induced astigmatism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25676","name":"Optx rad/uln dislc aqt/chrnc","description":"Open treatment of distal radioulnar dislocation, acute or chronic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68130","name":"Exc les conjunctiva adj scl","description":"Excision of lesion, conjunctiva; with adjacent sclera","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60100","name":"Biopsy of thyroid","description":"Biopsy thyroid, percutaneous core needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45388","name":"Colonoscopy w/ablation","description":"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2249.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54160","name":"Circumcision neonate","description":"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75635","name":"Ct angio abdominal arteries","description":"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87476","name":"Lyme dis dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia burgdorferi, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87500","name":"Vanomycin dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); vancomycin resistance (eg, enterococcus species van a, van b), amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87184","name":"Sc std disk method per plate","description":"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24371","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral and ulnar component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1504.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44126","name":"Enterectomy w/o taper cong","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; without tapering","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15576","name":"Pedicle e/n/e/l/ntroral","description":"Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, lips, or intraoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3107.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96921","name":"Excimer lsr psriasis 250-500","description":"Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","name":"Anes hrna rpr lmbr&vnt&/dehs","description":"Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27827","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of tibia only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47556","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with dilation of biliary duct stricture(s) with stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97545","name":"Work hardening","description":"Work hardening/conditioning; initial 2 hours","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19296","name":"Place po breast cath for rad","description":"Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; on date separate from partial mastectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28575","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73502","name":"X-ray exam hip uni 2-3 views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2001","name":"Post d/c h vst new pt 20 m","description":"Brief (20 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32673","name":"Thoracoscopy w/thymus resect","description":"Thoracoscopy, surgical; with resection of thymus, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":972.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77777","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26843","name":"Fusion of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94360","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31624","name":"Dx bronchoscope/lavage","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11300","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85670","name":"Thrombin time plasma","description":"Thrombin time; plasma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60254","name":"Extensive thyroid surgery","description":"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2204.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37208","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29879","name":"Arthrs kne srg abrasj arthrp","description":"Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61556","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; frontal or parietal bone flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1560.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35572","name":"Harvest femoropopliteal vein","description":"Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34712","name":"Tcat dlvr enhncd fixj dev","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35372","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; deep (profunda) femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45308","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63308","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (list separately in addition to codes for single segment)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87590","name":"N.gonorrhoeae dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46945","name":"Int hrhc lig 1 hroid w/o img","description":"Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93014","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30140","name":"Resect inferior turbinate","description":"Submucous resection inferior turbinate, partial or complete, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28730","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63308","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (list separately in addition to codes for single segment)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97112","name":"Neuromuscular reeducation","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19283","name":"Perq dev breast 1st strtctc","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including stereotactic guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93555","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31237","name":"Nsl/sins ndsc surg bx polypc","description":"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28446","name":"Opn osteochondrl agrft talus","description":"Open osteochondral autograft, talus (includes obtaining graft[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83835","name":"Assay of metanephrines","description":"Metanephrines","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1273.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25107","name":"Remove wrist joint cartilage","description":"Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43194","name":"Esophagoscp rig trnso rem fb","description":"Esophagoscopy, rigid, transoral; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21142","name":"Rcnstj midface lefort i 2pcs","description":"Reconstruction midface, lefort i; 2 pieces, segment movement in any direction, without bone graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38232","name":"Bone marrow harvest autolog","description":"Bone marrow harvesting for transplantation; autologous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82030","name":"Assay of adp & amp","description":"Adenosine, 5-monophosphate, cyclic (cyclic amp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6716.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33419","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; additional prosthesis(es) during same session (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53080","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; uncomplicated (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37217","name":"Stent placemt retro carotid","description":"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angioplasty, when performed, and radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84207","name":"Assay of vitamin b-6","description":"Pyridoxal phosphate (vitamin b-6)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63251","name":"Revise spinal cord vsls thrc","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2801.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61548","name":"Removal of pituitary gland","description":"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86696","name":"Herpes simplex type 2 test","description":"Antibody; herpes simplex, type 2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33766","name":"Shunt supr v/c p-art 1 lung","description":"Shunt; superior vena cava to pulmonary artery for flow to 1 lung (classical glenn procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69740","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0245","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42970","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or without anterior packs and/or cautery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87332","name":"Cytomegalovirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cytomegalovirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26785","name":"Treat finger dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed, single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54300","name":"Revision of penis","description":"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1660.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50250","name":"Opn abltj 1/> rnl mas crysrg","description":"Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78072","name":"Parathyrd planar w/spect&ct","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect), and concurrently acquired computed tomography (ct) for anatomical localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6233.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35490","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1220.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50576","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57420","name":"Exam of vagina w/scope","description":"Colposcopy of the entire vagina, with cervix if present;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52007","name":"Cysto urtrl cathj brush bx","description":"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44147","name":"Partial removal of colon","description":"Colectomy, partial; abdominal and transanal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1601.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29805","name":"Sho arthrs dx +- synovial bx","description":"Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9487","name":"Remote e/m est. pt 15mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65430","name":"Corneal smear","description":"Scraping of cornea, diagnostic, for smear and/or culture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82726","name":"Long chain fatty acids","description":"Very long chain fatty acids","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96934","name":"Rcm img acquisj&i&r ea addl","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":139.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85530","name":"Heparin-protamine tolerance","description":"Heparin-protamine tolerance test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28540","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19110","name":"Nipple exploration","description":"Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95125","name":"Immunotherapy 2/> injections","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 2 or more injections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4480","name":"Vabra aspirator","description":"Vabra aspirator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9485","name":"Remote e/m new pt 60mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21263","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1904.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90732","name":"Ppsv23 vacc 2 yrs+ subq/im","description":"Pneumococcal polysaccharide vaccine, 23-valent (ppsv23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43845","name":"Gastroplasty duodenal switch","description":"Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal switch)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49428","name":"Ligation of shunt","description":"Ligation of peritoneal-venous shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33925","name":"Rpr pul art unifocal w/o cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01850","name":"Anes vein f/arm wrst&hnd nos","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65875","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27267","name":"Cltx thigh fx","description":"Closed treatment of femoral fracture, proximal end, head; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22610","name":"Arthrd pst tq 1ntrspc thrc","description":"Arthrodesis, posterior or posterolateral technique, single interspace; thoracic (with lateral transverse technique, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30560","name":"Lysis intranasal synechia","description":"Lysis intranasal synechia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23331","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80152","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27306","name":"Incision of thigh tendon","description":"Tenotomy, percutaneous, adductor or hamstring; single tendon (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22510","name":"Perq cervicothoracic inject","description":"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64840","name":"Repair of leg nerve","description":"Suture of posterior tibial nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31631","name":"Bronchoscopy dilate w/stent","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of tracheal stent(s) (includes tracheal/bronchial dilation as required)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74221","name":"X-ray xm esophagus 2cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86063","name":"Antistreptolysin o screen","description":"Antistreptolysin 0; screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23505","name":"Cltx clavicular fx w/mnpj","description":"Closed treatment of clavicular fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2170","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4262.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73542","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27138","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; femoral component only, with or without allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31603","name":"Emer tracheostomy ttrach","description":"Tracheostomy, emergency procedure; transtracheal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85612","name":"Viper venom prothrombin time","description":"Russell viper venom time (includes venom); undiluted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3899.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33992","name":"Rmvl perq left heart vad","description":"Removal of percutaneous left heart ventricular assist device, arterial or arterial and venous cannula(s), at separate and distinct session from insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26116","name":"Exc hand tum deep < 1.5 cm","description":"Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); less than 1.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2643.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0001","name":"Alcohol and/or drug assess","description":"Alcohol and/or drug assessment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70488","name":"Ct maxillofacial w/o & w/dye","description":"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28525","name":"Treat toe fracture","description":"Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation, when performed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26665","name":"Treat thumb fracture","description":"Open treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85348","name":"Coagulation time otr method","description":"Coagulation time; other methods","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24066","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","name":"Anes cls px upr tib fib&/pat","description":"Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27696","name":"Repair of ankle ligaments","description":"Repair, primary, disrupted ligament, ankle; both collateral ligaments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34846","name":"Visc & infraren abd 2 prosth","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1920.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63046","name":"Lam facetec & foramot thrc","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28576","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29914","name":"Hip arthro w/femoroplasty","description":"Arthroscopy, hip, surgical; with femoroplasty (ie, treatment of cam lesion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43255","name":"Egd control bleeding any","description":"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87631","name":"Resp virus 3-5 targets","description":"Infectious agent detection by nucleic acid (dna or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0009","name":"Admin pneumococcal vaccine","description":"Administration of pneumococcal vaccine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3076.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92616","name":"Fees w/laryngeal sense test","description":"Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2996.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43647","name":"Lap impl electrode antrum","description":"Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23395","name":"Muscle transfer shoulder/arm","description":"Muscle transfer, any type, shoulder or upper arm; single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63078","name":"Spine disk surgery thorax","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15365","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15330","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68705","name":"Revise tear duct opening","description":"Correction of everted punctum, cautery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74249","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27635","name":"Remove lower leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43502","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, mallory-weiss)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52224","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of minor (less than 0.5 cm) lesion(s) with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34833","name":"Opn ilac art expos cndt crtj","description":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45341","name":"Sigmoidoscopy w/ultrasound","description":"Sigmoidoscopy, flexible; with endoscopic ultrasound examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48547","name":"Duodenal exclusion","description":"Duodenal exclusion with gastrojejunostomy for pancreatic injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1506.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32488","name":"Completion pneumonectomy","description":"Removal of lung, other than pneumonectomy; with all remaining lung following previous removal of a portion of lung (completion pneumonectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1918.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28072","name":"Removal of foot joint lining","description":"Synovectomy; metatarsophalangeal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","name":"Anes xtnsv sp&spi cord px","description":"Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65210","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27381","name":"Repair/graft kneecap tendon","description":"Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58410","name":"Suspension of uterus","description":"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with presacral sympathectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52010","name":"Cystoscopy & duct catheter","description":"Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86713","name":"Legionella antibody","description":"Antibody; legionella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46948","name":"Int hrhc tranal dartlzj 2+","description":"Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46255","name":"Remove int/ext hem 1 group","description":"Hemorrhoidectomy, internal and external, single column/group;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15826","name":"Rhytidectomy glblr frn lines","description":"Rhytidectomy; glabellar frown lines","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95724","name":"Eeg phy/qhp>60<84 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 60 hours, up to 84 hours of eeg recording, with video (veeg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92982","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64486","name":"Tap block unil by injection","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2066","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74340","name":"X-ray guide for gi tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott), including multiple fluoroscopies and images, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80438","name":"Trh stimulation panel","description":"Thyrotropin releasing hormone (trh) stimulation panel; 1 hour this panel must include the following: thyroid stimulating hormone (tsh) (84443 x 3)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31750","name":"Tracheoplasty cervical","description":"Tracheoplasty; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86941","name":"Hemolysins/agglutinins","description":"Hemolysins and agglutinins; incubated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64792","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; extensive (including malignant type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19301","name":"Partial mastectomy","description":"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58760","name":"Fimbrioplasty","description":"Fimbrioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11765","name":"Wedge excision skn nail fold","description":"Wedge excision of skin of nail fold (eg, for ingrown toenail)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92002","name":"Intrm oph exam new patient","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21554","name":"Exc neck tum deep 5 cm/>","description":"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443T","name":"R-t spctrl alys prst8 tiss","description":"Real-time spectral analysis of prostate tissue by fluorescence spectroscopy, including imaging guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45398","name":"Colonoscopy w/band ligation","description":"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87653","name":"Strep b dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group b, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21270","name":"Augmentation cheek bone","description":"Malar augmentation, prosthetic material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87341","name":"Hep b surface ag neutrlzj ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag) neutralization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76885","name":"Us exam infant hips dynamic","description":"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25415","name":"Repair radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; without graft (eg, compression technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95851","name":"Range of motion measurements","description":"Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20553","name":"Njx 1/mlt trigger points 3/>","description":"Injection(s); single or multiple trigger point(s), 3 or more muscles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3437.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24332","name":"Tenolysis triceps","description":"Tenolysis, triceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87808","name":"Trichomonas assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; trichomonas vaginalis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22513","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5394.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4855.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","name":"Anes opn rpr fx disrpj plvs","description":"Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19110","name":"Nipple exploration","description":"Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43312","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1324.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73522","name":"X-ray exam hips bi 3-4 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22852","name":"Remove spine fixation device","description":"Removal of posterior segmental instrumentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30580","name":"Repair upper jaw fistula","description":"Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37618","name":"Ligation major artery xtr","description":"Ligation, major artery (eg, post-traumatic, rupture); extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0513","name":"Prolong prev svcs, first 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76942","name":"Echo guide for biopsy","description":"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33320","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92533","name":"Caloric vestibular test","description":"Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes 4 tests)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44136","name":"Intestine transplant live","description":"Intestinal allotransplantation; from living donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81344","name":"Tbp gene detc abnor alleles","description":"Tbp (tata box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78800","name":"Rp loclzj tum 1 area 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36482","name":"Endoven ther chem adhes 1st","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58323","name":"Sperm washing","description":"Sperm washing for artificial insemination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90468","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78609","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); perfusion evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47000","name":"Needle biopsy of liver perq","description":"Biopsy of liver, needle; percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32320","name":"Free/remove chest lining","description":"Decortication and parietal pleurectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1275.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33958","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77059","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46710","name":"Repr per/vag pouch sngl proc","description":"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; transperineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":925.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86668","name":"Francisella tularensis","description":"Antibody; francisella tularensis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46924","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46938","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69662","name":"Revise middle ear bone","description":"Revision of stapedectomy or stapedotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87197","name":"Serum bactericidal titer","description":"Serum bactericidal titer (schlichter test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91010","name":"Esophagus motility study","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43219","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","name":"Anes gastrocnemius recession","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62258","name":"Replace brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2243.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49014","name":"Reexploration pelvic wound","description":"Re-exploration of pelvic wound with removal of preperitoneal pelvic packing, including repacking, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27681","name":"Release of lower leg tendons","description":"Tenolysis, flexor or extensor tendon, leg and/or ankle; multiple tendons (through separate incision[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1753","name":"Cath, intravas ultrasound","description":"Catheter, intravascular ultrasound","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70373","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86023","name":"Immunoglobulin assay","description":"Antibody identification; platelet associated immunoglobulin assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45315","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15111","name":"Epidrm agrft t/a/l ea addl","description":"Epidermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88172","name":"Cytp dx eval fna 1st ea site","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22514","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5370.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75994","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41825","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519T","name":"Rmv&rplcmt pg wcs lv both","description":"Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; both components (battery and transmitter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15152","name":"Tis cltr skn agrft t/a/l ea","description":"Tissue cultured skin autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75572","name":"Ct hrt w/3d image","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84445","name":"Assay of tsi globulin","description":"Thyroid stimulating immune globulins (tsi)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81234","name":"Dmpk gene detc abnor allele","description":"Dmpk (dm1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23100","name":"Arthrotomy glenhumrl jt w/bx","description":"Arthrotomy, glenohumeral joint, including biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","name":"Anes opn lwr l/a/f rad rescj","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48000","name":"Drainage of abdomen","description":"Placement of drains, peripancreatic, for acute pancreatitis;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1584.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75978","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0141","name":"Scr c/v cyto,autosys and md","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00756","name":"Anes hrna rpr diphrg hrna","description":"Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78454","name":"Ht musc image planar mult","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74251","name":"X-ray xm sm int 2cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4527","name":"Adult size pull-on lg","description":"Adult sized disposable incontinence product, protective underwear/pull-on, large size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32800","name":"Repair lung hernia","description":"Repair lung hernia through chest wall","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83068","name":"Hemoglobin unstable screen","description":"Hemoglobin; unstable, screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20680","name":"Removal of implant deep","description":"Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27041","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59852","name":"Induced abortion 1+njx hyst","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic injection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73721","name":"Mri jnt of lwr extre w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36522","name":"Photopheresis","description":"Photopheresis, extracorporeal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":347.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11283.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8421","name":"Ready gradient sleev/glov","description":"Gradient pressure aid (sleeve and glove combination), ready made","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00860","name":"Anes xtrprtl px lwr abd nos","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522T","name":"Prgrmg dev eval wcs ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80053","name":"Comprehen metabolic panel","description":"Comprehensive metabolic panel this panel must include the following: albumin (82040) bilirubin, total (82247) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphatase, alkaline (84075) potassium (84132) protein, total (84155) sodium ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56420","name":"I&d bartholins gland abscess","description":"Incision and drainage of bartholins gland abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24152","name":"Rad resection tum radial h/n","description":"Radical resection of tumor, radial head or neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54512","name":"Excise lesion testis","description":"Excision of extraparenchymal lesion of testis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15946","name":"Exc isch pr ulc prep mus flp","description":"Excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or myocutaneous flap or skin graft closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68810","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63700","name":"Repair of spinal herniation","description":"Repair of meningocele; less than 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1184.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":864.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92993","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86632","name":"Chlamydia igm antibody","description":"Antibody; chlamydia, igm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97150","name":"Group therapeutic procedures","description":"Therapeutic procedure(s), group (2 or more individuals)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74174","name":"Cta abd&plvs w/contrast","description":"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87485","name":"Chlmyd pneum dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2295.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89322","name":"Semen anal strict criteria","description":"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, kruger)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88313","name":"Special stains group 2","description":"Special stain including interpretation and report; group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47425","name":"Incision of bile duct","description":"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15976.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99447","name":"Ntrprof ph1/ntrnet/ehr 11-20","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","name":"Anes px art knee&pop nos","description":"Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74713","name":"Mri fetal ea addl gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86905","name":"Blood typing rbc antigens","description":"Blood typing, serologic; rbc antigens, other than abo or rh (d), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36410","name":"Vnpnxr 3yr/> phy/qhp dx/ther","description":"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33250","name":"Ablate heart dysrhythm focus","description":"Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, wolff-parkinson-white, atrioventricular node re-entry), tract(s) and/or focus (foci); without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61544","name":"Remove & treat brain lesion","description":"Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1741.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92352","name":"Fit aphakia spectcl monofocl","description":"Fitting of spectacle prosthesis for aphakia; monofocal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46606","name":"Anoscopy and biopsy","description":"Anoscopy; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4149","name":"Ef blenderized foods","description":"Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60650","name":"Laparoscopy adrenalectomy","description":"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66720","name":"Destruction ciliary body","description":"Ciliary body destruction; cryotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43831","name":"Gastrostomy open neonatal","description":"Gastrostomy, open; neonatal, for feeding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1945.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93541","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5800.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21182","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting less than 40 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53450","name":"Revision of urethra","description":"Urethromeatoplasty, with mucosal advancement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15782","name":"Dermabrasion other than face","description":"Dermabrasion; regional, other than face","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51045","name":"Incise bladder/drain ureter","description":"Cystotomy, with insertion of ureteral catheter or stent (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11440","name":"Exc face-mm b9+marg 0.5 cm/<","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1414.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75901","name":"Remove cva device obstruct","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42120","name":"Remove palate/lesion","description":"Resection of palate or extensive resection of lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86280","name":"Hemagglutination inhibition","description":"Hemagglutination inhibition test (hai)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25907","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27244","name":"Treat thigh fracture","description":"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant, with or without cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","name":"Anes px nrv musc upr a&e nos","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88367","name":"Insitu hybridization auto","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42892","name":"Revision of pharyngeal walls","description":"Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86185","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98943","name":"Chiropract manj xtrspinl 1/>","description":"Chiropractic manipulative treatment (cmt); extraspinal, 1 or more regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","name":"Anes clsd px shoulder joint","description":"Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89100","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23670","name":"Optx sho dislc fx","description":"Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95720","name":"Eeg phy/qhp ea incr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of eeg recording, interpretation and report after each 24-hour period; w","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19369","name":"Brst rcnstj 2 pdcl tram flap","description":"Breast reconstruction; with bipedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1317.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67041","name":"Vit for macular pucker","description":"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44377","name":"Small bowel endoscopy/biopsy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84140","name":"Assay of pregnenolone","description":"Pregnenolone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0238","name":"Oth resp proc, indiv","description":"Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11301","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43212","name":"Esophagoscop stent placement","description":"Esophagoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32551","name":"Insertion of chest tube","description":"Tube thoracostomy, includes connection to drainage system (eg, water seal), when performed, open (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29044","name":"Appl bdy cst sho to hip 1thi","description":"Application of body cast, shoulder to hips; including 1 thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27650","name":"Repair achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31253","name":"Nsl/sins ndsc total","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70543","name":"Mri orbt/fac/nck w/o &w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43239","name":"Egd biopsy single/multiple","description":"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3253.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49446","name":"Change g-tube to g-j perc","description":"Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62327","name":"Njx interlaminar lmbr/sac","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"Esrd svc pr day pt 12-19","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 12-19 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","name":"Anes px art lower leg emblc","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11424","name":"Exc h-f-nk-sp b9+marg 3.1-4","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68020","name":"Incise/drain eyelid lining","description":"Incision of conjunctiva, drainage of cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17281","name":"Dstr mal ls f/e/e/n/l/m .6-1","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61875","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27705","name":"Osteotomy tibia","description":"Osteotomy; tibia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44204","name":"Laparo partial colectomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1263.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25443","name":"Arthrp prostc dstl scph crpl","description":"Arthroplasty with prosthetic replacement; scaphoid carpal (navicular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83020","name":"Hemoglobin electrophoresis","description":"Hemoglobin fractionation and quantitation; electrophoresis (eg, a2, s, c, and/or f)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95018","name":"All tstg perq&iq drugs/biol","description":"Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with drugs or biologicals, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0641","name":"Multi-position stnd fram sys","description":"Standing frame/table system, multi-position (e.g., three-way stander), any size including pediatric, with or without wheels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2249.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26230","name":"Partial removal of hand bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); metacarpal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00942","name":"Anes vag px clptmy vgnc clpr","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); colpotomy, vaginectomy, colporrhaphy, and open urethral procedures","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1827.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15730","name":"Mdfc flap w/prsrv vasc pedcl","description":"Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94770","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63047","name":"Lam facetec & foramot lumbar","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84152","name":"Assay of psa complexed","description":"Prostate specific antigen (psa); complexed (direct measurement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33203","name":"Insert epicard eltrd endo","description":"Insertion of epicardial electrode(s); endoscopic approach (eg, thoracoscopy, pericardioscopy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54360","name":"Penis plastic surgery","description":"Plastic operation on penis to correct angulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62146","name":"Crnop w/autograft<5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85525","name":"Heparin neutralization","description":"Heparin neutralization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35470","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83662","name":"Foam stability fetal lung","description":"Fetal lung maturity assessment; foam stability test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26605","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; with manipulation, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28104","name":"Removal of foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60540","name":"Explore adrenal gland","description":"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26445","name":"Release hand/finger tendon","description":"Tenolysis, extensor tendon, hand or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31573","name":"Largsc w/ther injection","description":"Laryngoscopy, flexible; with therapeutic injection(s) (eg, chemodenervation agent or corticosteroid, injected percutaneous, transoral, or via endoscope channel), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64876","name":"Repair nerve/shorten bone","description":"Suture of nerve; requiring shortening of bone of extremity (list separately in addition to code for nerve suture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49520","name":"Rerepair ing hernia reduce","description":"Repair recurrent inguinal hernia, any age; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64615","name":"Chemodenerv musc migraine","description":"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2013","name":"Post-d/c h vst ext pt 75 m","description":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient fa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86039","name":"Antinuclear antibodies (ana)","description":"Antinuclear antibodies (ana); titer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59130","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; abdominal pregnancy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99239","name":"Hosp ip/obs dschrg mgmt >30","description":"Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82135","name":"Assay aminolevulinic acid","description":"Aminolevulinic acid, delta (ala)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21406","name":"Opn tx orbit fx w/o implant","description":"Open treatment of fracture of orbit, except blowout; without implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552T","name":"Low-level laser therapy","description":"Low-level laser therapy, dynamic photonic and dynamic thermokinetic energies, provided by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21046","name":"Remove mandible cyst complex","description":"Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54520","name":"Removal of testis","description":"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480T","name":"Fxjl abl lsr ea addl 100sqcm","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2, or each additional 1% of body surface area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4671","name":"Disposable cycler set","description":"Disposable cycler set used with cycler dialysis machine, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83150","name":"Assay of homovanillic acid","description":"Homovanillic acid (hva)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82742","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2086","name":"Off base opioid tx 70min","description":"Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22523","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5883.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80182","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86713","name":"Legionella antibody","description":"Antibody; legionella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49492","name":"Rpr ing hern premie blocked","description":"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36585","name":"Replace picvad cath","description":"Replacement, complete, of a peripherally inserted central venous access device, with subcutaneous port, through same venous access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2031.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95801","name":"Slp stdy unatnd w/anal","description":"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77371","name":"Srs multisource","description":"Radiation treatment delivery, stereotactic radiosurgery (srs), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source cobalt 60 based","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86665","name":"Epstein-barr capsid vca","description":"Antibody; epstein-barr (eb) virus, viral capsid (vca)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27170","name":"Repair/graft femur head/neck","description":"Bone graft, femoral head, neck, intertrochanteric or subtrochanteric area (includes obtaining bone graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":996.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26477","name":"Tendon shortening","description":"Shortening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25441","name":"Arthrp w/prostc dstl rds","description":"Arthroplasty with prosthetic replacement; distal radius","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99307","name":"Sbsq nf care sf mdm 10","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73719","name":"Mri lower extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2086","name":"Off base opioid tx 70min","description":"Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34717","name":"Evasc rpr a-iliac ndgft","description":"Endovascular repair of iliac artery at the time of aorto-iliac artery endograft placement by deployment of an iliac branched endograft including pre-procedure sizing and device selection, all ipsilateral selective iliac artery catheterization(s), all associated radiological supervision and interpret","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72083","name":"X-ray exam entire spi 4/5 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0101","name":"Ca screen;pelvic/breast exam","description":"Cervical or vaginal cancer screening; pelvic and clinical breast examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20005","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71555","name":"Mri angio chest w or w/o dye","description":"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61313","name":"Crnec/crnot sttl icere","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1811.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":54.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36160","name":"Establish access to aorta","description":"Introduction of needle or intracatheter, aortic, translumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38530","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, internal mammary node(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95977","name":"Alys cplx cn npgt prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31653","name":"Bronch ebus samplng 3/> node","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67318","name":"Revise eye muscle(s)","description":"Strabismus surgery, any procedure, superior oblique muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86617","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease) confirmatory test (eg, western blot or immunoblot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00756","name":"Anes hrna rpr diphrg hrna","description":"Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87651","name":"Strep a dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80048","name":"Basic metabolic pnl total ca","description":"Basic metabolic panel (calcium, total) this panel must include the following: calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47300","name":"Surgery for liver lesion","description":"Marsupialization of cyst or abscess of liver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57454","name":"Bx/curett of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58822","name":"Drain ovary abscess percut","description":"Drainage of ovarian abscess; abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93237","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1520.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19318","name":"Breast reduction","description":"Breast reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82975","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3461.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1823.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25927","name":"Amputation of hand","description":"Transmetacarpal amputation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92548","name":"Cdp-sot 6 cond w/i&r","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1751.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62200","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy, third ventricle;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566T","name":"Autol cell implt adps njx","description":"Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; injection of cellular implant into knee joint including ultrasound guidance, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","name":"Anes spine manipulation","description":"Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0407","name":"Inpt/tele follow up 25","description":"Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97033","name":"App mdlty 1+iontphrsis ea 15","description":"Application of a modality to 1 or more areas; iontophoresis, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3544.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1852.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93287","name":"Peri-px device eval & prgr","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24077","name":"Rad rescj tum tiss a/e <5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0076T","name":"S&i stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7682.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83885","name":"Assay of nickel","description":"Nickel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93314","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34711","name":"Dlyd plmt xtn prosth ea addl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17106","name":"Dstr cut vsc prlf les<10sqcm","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21282","name":"Lateral canthopexy","description":"Lateral canthopexy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63709","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":979.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27665","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82525","name":"Assay of copper","description":"Copper","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6412","name":"Occlusive eye patch","description":"Eye patch, occlusive, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88172","name":"Cytp dx eval fna 1st ea site","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75790","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5508","name":"Diabetic deluxe shoe","description":"For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1550.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KM","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27216","name":"Treat pelvic ring fracture","description":"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral (includes ipsilateral ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86702","name":"Hiv-2 antibody","description":"Antibody; hiv-2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97110","name":"Therapeutic exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64895","name":"Nrv grf mltst hnd/foot <4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69140","name":"Remove ear canal lesion(s)","description":"Excision exostosis(es), external auditory canal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82735","name":"Assay of fluoride","description":"Fluoride","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76377","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19304","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67030","name":"Incise inner eye strands","description":"Discission of vitreous strands (without removal), pars plana approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83633","name":"Test urine for lactose","description":"Lactose, urine, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35305","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; tibial or peroneal artery, initial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25251","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; complicated, including total wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97016","name":"Vasopneumatic device therapy","description":"Application of a modality to 1 or more areas; vasopneumatic devices","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76000","name":"Fluoroscopy <1 hr phys/qhp","description":"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95015","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A7011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35560","name":"Art byp grft aortorenal","description":"Bypass graft, with vein; aortorenal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1506.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44015","name":"Insert needle cath bowel","description":"Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27340","name":"Removal of kneecap bursa","description":"Excision, prepatellar bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27889","name":"Ankle disarticulation","description":"Ankle disarticulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2411.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57305","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35471","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2059.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28103","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4250","name":"Urine reagent strips/tablets","description":"Urine test or reagent strips or tablets (100 tablets or strips)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86651","name":"Encephalitis californ antbdy","description":"Antibody; encephalitis, california (la crosse)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1790.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25455","name":"Epiphysl arrst dstl rds&ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius and ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3253","name":"Shoe molded plastazote cust","description":"Foot, molded shoe plastazote (or similar) custom fitted, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61711","name":"Fusion of skull arteries","description":"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9143","name":"Warfarin respon genetic test","description":"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0076T","name":"S&i stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47010","name":"Hepatot opn drg absc/cst 1/2","description":"Hepatotomy, for open drainage of abscess or cyst, 1 or 2 stages","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35501","name":"Art byp grft ipsilat carotid","description":"Bypass graft, with vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50715","name":"Release of ureter","description":"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49557","name":"Rerepair fem hernia blocked","description":"Repair recurrent femoral hernia; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2083","name":"Visit esketamine, > 56m","description":"Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92317","name":"C-lens fitg tech corneosclrl","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneoscleral lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86645","name":"Cmv antibody igm","description":"Antibody; cytomegalovirus (cmv), igm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26111","name":"Exc hand les sc 1.5 cm/>","description":"Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; 1.5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49423","name":"Exchange drainage catheter","description":"Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22214","name":"Incis 1 vertebral seg lumbar","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85335","name":"Factor inhibitor test","description":"Factor inhibitor test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11952","name":"Subq njx fil matrl 5.1-10cc","description":"Subcutaneous injection of filling material (eg, collagen); 5.1 to 10.0 cc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28262","name":"Revision of foot and ankle","description":"Capsulotomy, midfoot; extensive, including posterior talotibial capsulotomy and tendon(s) lengthening (eg, resistant clubfoot deformity)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83893","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86689","name":"Htlv/hiv confirmj antibody","description":"Antibody; htlv or hiv antibody, confirmatory test (eg, western blot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87901","name":"Nfct agt gntyp alys hiv1 rev","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hiv-1, reverse transcriptase and protease regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15116","name":"Epdrm agrft f/s/n/h/f/g/m ea","description":"Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"Electrocardiogram complete","description":"Electrocardiogram, routine ecg with at least 12 leads; with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26641","name":"Treat thumb dislocation","description":"Closed treatment of carpometacarpal dislocation, thumb, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11042","name":"Dbrdmt subq tis 1st 20sqcm/<","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36834","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84210","name":"Assay of pyruvate","description":"Pyruvate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3415.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84466","name":"Assay of transferrin","description":"Transferrin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68815","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69620","name":"Myringoplasty","description":"Myringoplasty (surgery confined to drumhead and donor area)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61559","name":"Excision of skull/sutures","description":"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining grafts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2193.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1754.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92521","name":"Evaluation of speech fluency","description":"Evaluation of speech fluency (eg, stuttering, cluttering)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","name":"Anes px art fem art emblc","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery embolectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31600","name":"Planned tracheostomy","description":"Tracheostomy, planned (separate procedure);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2710.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36246","name":"Ins cath abd/l-ext art 2nd","description":"Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4456.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6004","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0075T","name":"Perq stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78227","name":"Hepatobil syst image w/drug","description":"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30000","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal, internal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","name":"Anes px nrv msc upr a&e tnot","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87483","name":"Cns dna amp probe type 12-25","description":"Infectious agent detection by nucleic acid (dna or rna); central nervous system pathogen (eg, neisseria meningitidis, streptococcus pneumoniae, listeria, haemophilus influenzae, e. coli, streptococcus agalactiae, enterovirus, human parechovirus, herpes simplex virus type 1 and 2, human herpesvirus 6","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2169.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38102","name":"Removal of spleen total","description":"Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (list in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64555","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85240","name":"Clot factor viii ahg 1 stage","description":"Clotting; factor viii (ahg), 1-stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40816","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86277","name":"Growth hormone antibody","description":"Growth hormone, human (hgh), antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1935.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64505","name":"N block spenopalatine gangl","description":"Injection, anesthetic agent; sphenopalatine ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99409","name":"Audit/dast over 30 min","description":"Alcohol and/or substance (other than tobacco) abuse structured screening (eg, audit, dast), and brief intervention (sbi) services; greater than 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86890","name":"Autologous blood process","description":"Autologous blood or component, collection processing and storage; predeposited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28296","name":"Cor hlx vlgs dstl mtar osteo","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26765","name":"Treat finger fracture each","description":"Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation, when performed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70549","name":"Mr angiograph neck w/o&w/dye","description":"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64634","name":"Destroy c/th facet jnt addl","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); cervical or thoracic, each additional facet joint (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93298","name":"Rem interrog dev eval scrms","description":"Interrogation device evaluation(s), (remote) up to 30 days; subcutaneous cardiac rhythm monitor system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77049","name":"Mri breast c-+ w/cad bi","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87534","name":"Hiv-1 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","name":"Anes thoracotomy px nos","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30901","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83904","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6079.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40805","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23078","name":"Rad rescj tum shoulder 5cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69550","name":"Exc aurl glomus tum trnscanl","description":"Excision aural glomus tumor; transcanal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93294","name":"Rem interrog evl pm/ldls pm","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, or leadless pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20931","name":"Sp bone algrft struct add-on","description":"Allograft, structural, for spine surgery only (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22855","name":"Removal anterior instrmj","description":"Removal of anterior instrumentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":982.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94775","name":"Ped home apnea mntr att only","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; monitor attachment only (includes hook-up, initiation of recording and disconnection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1631.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88372","name":"Protein analysis w/probe","description":"Protein analysis of tissue by western blot, with interpretation and report; immunological probe for band identification, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"U0004","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4575","name":"Hyperbaric o2 chamber disps","description":"Topical hyperbaric oxygen chamber, disposable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92240","name":"Icg angiography i&r uni/bi","description":"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96522","name":"Refill/maint pump/resvr syst","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4676.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","name":"Anes thrcm px trach&bronchi","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea and bronchi","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66165","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4495","name":"Thigh length surg stocking","description":"Surgical stockings thigh length, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2317.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32905","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95921","name":"Autonomic nrv parasym inervj","description":"Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded r-r interval, valsalva ratio, and 30:15 ratio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33955","name":"Ecmo/ecls insj ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","name":"Anes maj lwr adb vsl ivc lig","description":"Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43117","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (ivor lewis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2708.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17272","name":"Dstr mal les s/n/h/f/g 1.1-2","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92602","name":"Reprogram cochlear implt <7","description":"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"Esrd home pt serv p mo 12-19","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93284","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous impla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1522.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3966.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":7529.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516T","name":"Insj wcs lv eltrd only","description":"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; electrode only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":217.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20670","name":"Removal implant superficial","description":"Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20982","name":"Ablate bone tumor(s) perq","description":"Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74170","name":"Ct abd wo cntrst flwd cntrst","description":"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90673","name":"Riv3 vaccine no preserv im","description":"Influenza virus vaccine, trivalent (riv3), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37222","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43401","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75790","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93298","name":"Rem interrog dev eval scrms","description":"Interrogation device evaluation(s), (remote) up to 30 days; subcutaneous cardiac rhythm monitor system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56634","name":"Vlvctmy rad comp uni lymphad","description":"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2055.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95922","name":"Autonomic nrv adrenrg inervj","description":"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92273","name":"Full field erg w/i&r","description":"Electroretinography (erg), with interpretation and report; full field (ie, fferg, flash erg, ganzfeld erg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","name":"Anes px fcl b1/skl rad surg","description":"Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2025","name":"Dis site tele svcs rhc/fqhc","description":"Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43242","name":"Egd us fine needle bx/aspir","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8379.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":5797.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38206","name":"Harvest auto stem cells","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61690","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2000.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26341","name":"Manipulat palm cord post inj","description":"Manipulation, palmar fascial cord (ie, dupuytrens cord), post enzyme injection (eg, collagenase), single cord","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95800","name":"Slp stdy unattended","description":"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12054","name":"Intmd rpr face/mm 7.6-12.5cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20650","name":"Insert and remove bone pin","description":"Insertion of wire or pin with application of skeletal traction, including removal (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35261","name":"Rpr blvsl grf oth/thn vn nck","description":"Repair blood vessel with graft other than vein; neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21339","name":"Open nasoethmoid fx w/ fixj","description":"Open treatment of nasoethmoid fracture; with external fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442T","name":"Abltj perc plex/trncl nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11311","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27652","name":"Repair/graft achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon; with graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99479","name":"Sbsq ic lbw inf 1,500-2,500","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering low birth weight infant (present body weight of 1,500-2,500 grams)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22526","name":"Idet single level","description":"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88285","name":"Chromosome count additional","description":"Chromosome analysis; additional cells counted, each study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58546","name":"Laparo-myomectomy complex","description":"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62350","name":"Implant spinal canal cath","description":"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87482","name":"Candida dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86384","name":"Nitroblue tetrazolium dye","description":"Nitroblue tetrazolium dye test (ntd)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1582.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12034","name":"Intmd rpr s/tr/ext 7.6-12.5","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63302","name":"Remove vert xdrl body thrlmb","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1996.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82652","name":"Vit d 1 25-dihydroxy","description":"Vitamin d; 1, 25 dihydroxy, includes fraction(s), if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41135","name":"Tongue and neck surgery","description":"Glossectomy; partial, with unilateral radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1683.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28315","name":"Removal of sesamoid bone","description":"Sesamoidectomy, first toe (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61516","name":"Crnec treph exc cyst sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1710.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97004","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15004","name":"Wound prep f/n/hf/g","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of bo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1751.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97112","name":"Neuromuscular reeducation","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65220","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, without slit lamp","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41821","name":"Excision of gum flap","description":"Operculectomy, excision pericoronal tissues","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95130","name":"Immntx 1 sting insect","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; single stinging insect venom","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27226","name":"Treat hip wall fracture","description":"Open treatment of posterior or anterior acetabular wall fracture, with internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","name":"Anes art sho&ax ax-brch arsm","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72130","name":"Ct chest spine w/o & w/dye","description":"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90845","name":"Psychoanalysis","description":"Psychoanalysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4491.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1999.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21935","name":"Resect back tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82565","name":"Assay of creatinine","description":"Creatinine; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32960","name":"Therapeutic pneumothorax","description":"Pneumothorax, therapeutic, intrapleural injection of air","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4465","name":"Non-elastic extremity binder","description":"Non-elastic binder for extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10080","name":"I&d pilonidal cyst simple","description":"Incision and drainage of pilonidal cyst; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0075T","name":"Perq stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65290","name":"Repair of eye socket wound","description":"Repair of wound, extraocular muscle, tendon and/or tenons capsule","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77002","name":"Needle localization by xray","description":"Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46221","name":"Ligation of hemorrhoid(s)","description":"Hemorrhoidectomy, internal, by rubber band ligation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33517","name":"Cabg artery-vein single","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0439","name":"Ppps, subseq visit","description":"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28660","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73706","name":"Ct angio lwr extr w/o&w/dye","description":"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86653","name":"Encephaltis st louis antbody","description":"Antibody; encephalitis, st. louis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74240","name":"X-ray xm upr gi trc 1cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50385","name":"Change stent via transureth","description":"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77083","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11308","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75902","name":"Remove cva lumen obstruct","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9043","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3395.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92616","name":"Fees w/laryngeal sense test","description":"Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0239","name":"Oth resp proc, group","description":"Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23220","name":"Radical rescj tumor prox hum","description":"Radical resection of tumor, proximal humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90813","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50405","name":"Revision of kidney/ureter","description":"Pyeloplasty (foley y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital kidney abnormality, secondary pyeloplasty, solitary kidney, calycoplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1128.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71552","name":"Mri chest w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85347","name":"Coagulation time activated","description":"Coagulation time; activated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87652","name":"Strep a dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99222","name":"1st hosp ip/obs moderate 55","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10970.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]},{"negotiated_type":"negotiated","negotiated_rate":4445.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87542","name":"Legion pneumo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15840","name":"Nerve palsy fascial graft","description":"Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69631","name":"Repair eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":713.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0186","name":"Dstry eye lesn,fdr vssl tech","description":"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42320","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary, external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21209","name":"Reduction of facial bones","description":"Osteoplasty, facial bones; reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14040","name":"Tis trnfr f/c/c/m/n/a/g/h/f","description":"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67036","name":"Removal of inner eye fluid","description":"Vitrectomy, mechanical, pars plana approach;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88305","name":"Tissue exam by pathologist","description":"Level iv - surgical pathology, gross and microscopic examination abortion - spontaneous/missed artery, biopsy bone marrow, biopsy bone exostosis brain/meninges, other than for tumor resection breast, biopsy, not requiring microscopic evaluation of surgical margins breast, reduction mammoplasty bronc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43200","name":"Esophagoscopy flexible brush","description":"Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89190","name":"Nasal smear for eosinophils","description":"Nasal smear for eosinophils","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22101","name":"Remove part thorax vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71035","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4376.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71270","name":"Ct thorax dx c-/c+","description":"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43235","name":"Egd diagnostic brush wash","description":"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27087","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15271","name":"Skin sub graft trnk/arm/leg","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70558","name":"Mri brain w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78472","name":"Gated heart planar single","description":"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86698","name":"Histoplasma antibody","description":"Antibody; histoplasma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35460","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4540","name":"Reusable underpad chair size","description":"Incontinence product, protective underpad, reusable, chair size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92060","name":"Sensorimotor examination","description":"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27161","name":"Incision of neck of femur","description":"Osteotomy, femoral neck (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99355","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59074","name":"Fetal fluid drainage w/us","description":"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85397","name":"Clotting funct activity","description":"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, adamts-13), each analyte","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87580","name":"M.pneumon dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99235","name":"Hosp ip/obs same date mod 70","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encount","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7031.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0454","name":"Md document visit by npp","description":"Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8687","name":"Implt nrostm pls gen dua rec","description":"Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37700","name":"Ligation&div long saph vein","description":"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77058","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92986","name":"Revision of aortic valve","description":"Percutaneous balloon valvuloplasty; aortic valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42860","name":"Excision of tonsil tags","description":"Excision of tonsil tags","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29807","name":"Sho arthrs srg rpr slap les","description":"Arthroscopy, shoulder, surgical; repair of slap lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0443","name":"Brief alcohol misuse counsel","description":"Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74247","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93890","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28315","name":"Removal of sesamoid bone","description":"Sesamoidectomy, first toe (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62294","name":"Injection into spinal artery","description":"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46280","name":"Remove anal fist complex","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86078","name":"Phys blood bank serv reactj","description":"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24931","name":"Amputate upper arm & implant","description":"Amputation, arm through humerus; with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27422","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, campbell, goldwaite type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29846","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84146","name":"Assay of prolactin","description":"Prolactin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87538","name":"Hiv-2 probe&revrse trnscripj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-2, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60300","name":"Aspir/inj thyroid cyst","description":"Aspiration and/or injection, thyroid cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11976","name":"Remove contraceptive capsule","description":"Removal, implantable contraceptive capsules","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82164","name":"Angiotensin i enzyme test","description":"Angiotensin i - converting enzyme (ace)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0393","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64647","name":"Chemodenerv trunk musc 6/>","description":"Chemodenervation of trunk muscle(s); 6 or more muscles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13827.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1885.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1696.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61542","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1721.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78266","name":"Gstr empt img sm bwl&colon","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27524","name":"Treat kneecap fracture","description":"Open treatment of patellar fracture, with internal fixation and/or partial or complete patellectomy and soft tissue repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74330","name":"X-ray bile/panc endoscopy","description":"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":928.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93875","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96413","name":"Chemo iv infusion 1 hr","description":"Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75724","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66762","name":"Revision of iris","description":"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77334","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33516","name":"Cabg vein six or more","description":"Coronary artery bypass, vein only; 6 or more coronary venous grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2354.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74301","name":"X-rays at surgery add-on","description":"Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25360","name":"Revision of ulna","description":"Osteotomy; ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77408","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44340","name":"Revision of colostomy","description":"Revision of colostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90828","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35241","name":"Rpr blvsl vn grf ntrthrc w/b","description":"Repair blood vessel with vein graft; intrathoracic, with bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1243.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58662","name":"Laparoscopy excise lesions","description":"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15736","name":"Muscle-skin graft arm","description":"Muscle, myocutaneous, or fasciocutaneous flap; upper extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":790.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72159","name":"Mr angio spine w/o&w/dye","description":"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7486.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27591","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; immediate fitting technique including first cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33612","name":"Repair double ventricle","description":"Repair of double outlet right ventricle with intraventricular tunnel repair; with repair of right ventricular outflow tract obstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1743.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88307","name":"Tissue exam by pathologist","description":"Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86830","name":"Hla class i phenotype qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); antibody identification by qualitative panel using complete hla phenotypes, hla class i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94452","name":"Hast w/i&r phys/qhp","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36225","name":"Place cath subclavian art","description":"Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77021","name":"Mri guidance ndl plmt rs&i","description":"Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57135","name":"Excision vaginal cyst/tumor","description":"Excision of vaginal cyst or tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72148","name":"Mri lumbar spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74283","name":"Ther nma rdctj intus/obstrcj","description":"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92133","name":"Cptrzd oph dx img pst sgm on","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; optic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43842","name":"Gstr rstcv px v-banded gstp","description":"Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35626","name":"Bpg aor-subcla/innom/carotid","description":"Bypass graft, with other than vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1387.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KC","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31238","name":"Nsl/sins ndsc srg nsl hemrrg","description":"Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93281","name":"Pm device progr eval multi","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35480","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3173.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","name":"Anes nrv msc upr a&e tnplsty","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","name":"Anes xtrprtl lwr abd rnl px","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44143","name":"Partial removal of colon","description":"Colectomy, partial; with end colostomy and closure of distal segment (hartmann type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33224","name":"Insert pacing lead & connect","description":"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, with attachment to previously placed pacemaker or implantable defibrillator pulse generator (including revision of pocket, removal, insertion, and/or replacement of existing generator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4540","name":"Reusable underpad chair size","description":"Incontinence product, protective underpad, reusable, chair size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31629","name":"Bronchoscopy/needle bx each","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95808","name":"Polysom any age 1-3> param","description":"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15793","name":"Chemical peel nonfacial drm","description":"Chemical peel, nonfacial; dermal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":52.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5339.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67921","name":"Repair eyelid defect","description":"Repair of entropion; suture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32555","name":"Aspirate pleura w/ imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69420","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24330","name":"Flexor-plasty elbow","description":"Flexor-plasty, elbow (eg, steindler type advancement);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60522","name":"Removal of thymus gland","description":"Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27500","name":"Treatment of thigh fracture","description":"Closed treatment of femoral shaft fracture, without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84234","name":"Assay of progesterone","description":"Receptor assay; progesterone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4266","name":"Diaphragm","description":"Diaphragm for contraceptive use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83570","name":"Assay of idh enzyme","description":"Isocitric dehydrogenase (idh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01810","name":"Anes px nrv musc f/arm wrst","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29280","name":"Strapping of hand or finger","description":"Strapping; hand or finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0214T","name":"Njx paravert w/us cer/thor","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86077","name":"Phys blood bank serv xmatch","description":"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36513","name":"Apheresis platelets","description":"Therapeutic apheresis; for platelets","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90953","name":"Esrd serv 1 visit p mo <2yrs","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578T","name":"Rem interrog dev icds phys","description":"Interrogation device evaluation(s) (remote), up to 90 days, substernal lead implantable cardioverter-defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23931","name":"I&d upr a/e bursa","description":"Incision and drainage, upper arm or elbow area; bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0481","name":"Intrpulmnry percuss vent sys","description":"Intrapulmonary percussive ventilation system and related accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2508.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61315","name":"Crnec/crnot ittl ntracereblr","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1890.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63710","name":"Graft repair of spine defect","description":"Dural graft, spinal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74363","name":"X-ray bile duct dilation","description":"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86615","name":"Bordetella antibody","description":"Antibody; bordetella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78814","name":"Pet image w/ct lmtd","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92560","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95923","name":"Autonomic nrv syst funj test","description":"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61567","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2349.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84260","name":"Assay of serotonin","description":"Serotonin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36560","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; younger than 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28400","name":"Cltx calcaneal fx w/o mnpj","description":"Closed treatment of calcaneal fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83930","name":"Assay of blood osmolality","description":"Osmolality; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37249","name":"Trluml balo angiop addl vein","description":"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; each additional vein (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61799","name":"Srs cran les complex addl","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63709","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":979.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61613","name":"Remove aneurysm sinus","description":"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3017.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26685","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9603","name":"One-way allow prorated miles","description":"Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72158","name":"Mri lumbar spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33935","name":"Transplantation heart/lung","description":"Heart-lung transplant with recipient cardiectomy-pneumonectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4330.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50542","name":"Laparo ablate renal mass","description":"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44720","name":"Prep donor intestine/venous","description":"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; venous anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76885","name":"Us exam infant hips dynamic","description":"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33768","name":"Anast cavopulm sec sup v/c","description":"Anastomosis, cavopulmonary, second superior vena cava (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63744","name":"Revision of spinal shunt","description":"Replacement, irrigation or revision of lumbosubarachnoid shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62370","name":"Anl sp inf pmp w/mdreprg&fil","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill (requiring skill of a physician or other qualified health care professional)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","name":"Anes px vn upr arm&elbw nos","description":"Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58292","name":"Vag hyst t/o & repair compl","description":"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56640","name":"Vlvctmy rad comp w/lymphadec","description":"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58822","name":"Drain ovary abscess percut","description":"Drainage of ovarian abscess; abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8189","name":"Trach supply noc","description":"Tracheostomy supply, not otherwise classified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446T","name":"Insj impltbl glucose sensor","description":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation and patient training","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1522.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74221","name":"X-ray xm esophagus 2cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67005","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66987","name":"Xcapsl ctrc rmvl cplx w/ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43771","name":"Lap revise gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45395","name":"Lap removal of rectum","description":"Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1572.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28150","name":"Removal of toe","description":"Phalangectomy, toe, each toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95060","name":"Oph mucous membrane tests","description":"Ophthalmic mucous membrane tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11451","name":"Exc skn hdrdnt ax complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54420","name":"Revision of penis","description":"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28108","name":"Removal of toe lesions","description":"Excision or curettage of bone cyst or benign tumor, phalanges of foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45172","name":"Exc rect tum transanal full","description":"Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15852","name":"Dressing change not for burn","description":"Dressing change (for other than burns) under anesthesia (other than local)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15944","name":"Exc isch pr ulc skn flp clsr","description":"Excision, ischial pressure ulcer, with skin flap closure;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36473","name":"Endovenous mchnchem 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66174","name":"Trluml dil aq o/f can w/o st","description":"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); without retention of device or stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L9900","name":"O&p supply/accessory/service","description":"Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs l code","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33228","name":"Remv&replc pm gen dual lead","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50395","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69310","name":"Rebuild outer ear canal","description":"Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3827.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"Family psytx w/o pt 50 min","description":"Family psychotherapy (without the patient present), 50 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21720","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; without cast application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49411","name":"Ins mark abd/pel for rt perq","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93291","name":"Interrog dev eval scrms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; subcutaneous cardiac rhythm monitor system, including heart rhythm derived data analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37191","name":"Ins endovas vena cava filtr","description":"Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1937.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20916.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35301","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":996.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35907","name":"Excision graft abdomen","description":"Excision of infected graft; abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1681.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83874","name":"Assay of myoglobin","description":"Myoglobin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4226.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23030","name":"I&d shoulder deep absc/hmtma","description":"Incision and drainage, shoulder area; deep abscess or hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"Off/op cnsltj new/est low 30","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42836","name":"Removal of adenoids","description":"Adenoidectomy, secondary; age 12 or over","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31646","name":"Brnchsc w/ther aspir sbsq","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92313","name":"C-lens fitg corneosclrl lens","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneoscleral lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62180","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy (torkildsen type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1461.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61490","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1556.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36572","name":"Insj picc rs&i <5 yr","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; younger than 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47612","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with choledochoenterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93297","name":"Rem interrog dev eval icpms","description":"Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors, analysis, review(s) and report(s) by a physician or other quali","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84402","name":"Assay of free testosterone","description":"Testosterone; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11900.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26440","name":"Release palm/finger tendon","description":"Tenolysis, flexor tendon; palm or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21159","name":"Rcnst mdfc lfrtiii advm wo i","description":"Reconstruction midface, lefort iii (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); without lefort i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2119.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26844","name":"Fusion/graft of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85536","name":"Iron stain peripheral blood","description":"Iron stain, peripheral blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58285","name":"Extensive hysterectomy","description":"Vaginal hysterectomy, radical (schauta type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94645","name":"Cont inhlj tx each addl hour","description":"Continuous inhalation treatment with aerosol medication for acute airway obstruction; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64820","name":"Sympathectomy digital artery","description":"Sympathectomy; digital arteries, each digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19125","name":"Excision breast lesion","description":"Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88334","name":"Path consltj surg cyto xm ea","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29450","name":"Application clubfoot cast","description":"Application of clubfoot cast with molding or manipulation, long or short leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75630","name":"X-ray aorta leg arteries","description":"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21750","name":"Repair of sternum separation","description":"Closure of median sternotomy separation with or without debridement (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58140","name":"Myomectomy abdom method","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8265","name":"Haberman feeder","description":"Haberman feeder for cleft lip/palate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54500","name":"Biopsy of testis","description":"Biopsy of testis, needle (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93541","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87166","name":"Dark field exam w/o collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93227","name":"Xtrnl ecg rec<48 hr r&i","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28445","name":"Optx talus fracture","description":"Open treatment of talus fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21255","name":"Reconstruct lower jaw bone","description":"Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77071","name":"Mnl appl strs jt radiography","description":"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99148","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75959","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93350","name":"Stress tte only","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43510","name":"Surgical opening of stomach","description":"Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, celestin or mousseaux-barbin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35472","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26516","name":"Fusion of knuckle joint","description":"Capsulodesis, metacarpophalangeal joint; single digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78483","name":"Heart first pass multiple","description":"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27070","name":"Part remove hip bone super","description":"Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23665","name":"Cltx sho dslc fx gr hmrl tbr","description":"Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43273","name":"Endoscopic pancreatoscopy","description":"Endoscopic cannulation of papilla with direct visualization of pancreatic/common bile duct(s) (list separately in addition to code(s) for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42100","name":"Biopsy roof of mouth","description":"Biopsy of palate, uvula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84600","name":"Assay of volatiles","description":"Volatiles (eg, acetic anhydride, diethylether)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12056","name":"Intmd rpr face/mm 20.1-30.0","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27465","name":"Shortening of thigh bone","description":"Osteoplasty, femur; shortening (excluding 64876)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82649","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67225","name":"Eye photodynamic ther add-on","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (list separately in addition to code for primary eye treatment)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64555","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42510","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with ligation of both submandibular (whartons) ducts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30220","name":"Insert nasal septal button","description":"Insertion, nasal septal prosthesis (button)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90827","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","name":"Anes ther ivntl rad artl nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","name":"Anes all px neck nos 1yr/>","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33251","name":"Ablate heart dysrhythm focus","description":"Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, wolff-parkinson-white, atrioventricular node re-entry), tract(s) and/or focus (foci); with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1412.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82554","name":"Creatine isoforms","description":"Creatine kinase (ck), (cpk); isoforms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3651","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0108T","name":"Cool quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using cooling stimuli to assess small nerve fiber sensation and hyperalgesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28546","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3160","name":"Shoe styled positioning dev","description":"Foot, adjustable shoe-styled positioning device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4203.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","name":"Anes all px nck ndl bx thyr","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15110","name":"Epidrm agrft t/a/l 1st 100","description":"Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39540","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; acute","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40490","name":"Biopsy of lip","description":"Biopsy of lip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47135","name":"Transplantation of liver","description":"Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4521.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0441","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","name":"Anes px arteries upr leg nos","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31720","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); nasotracheal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53860","name":"Transurethral rf treatment","description":"Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1699.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80050","name":"General health panel","description":"General health panel this panel must include the following: comprehensive metabolic panel (80053) blood count, complete (cbc), automated and automated differential wbc count (85025 or 85027 and 85004) or blood count, complete (cbc), automated (85027) and appropriate manual differential wbc count (85","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01758","name":"Anes opn/arthrs elbw exc cst","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; excision of cyst or tumor of humerus","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36473","name":"Endovenous mchnchem 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49656","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25001","name":"Incise flexor carpi radialis","description":"Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77413","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64820","name":"Sympathectomy digital artery","description":"Sympathectomy; digital arteries, each digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0700","name":"Safety equipment","description":"Safety equipment, device or accessory, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28090","name":"Removal of foot lesion","description":"Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86704","name":"Hep b core antibody total","description":"Hepatitis b core antibody (hbcab); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36482","name":"Endoven ther chem adhes 1st","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27538","name":"Treat knee fracture(s)","description":"Closed treatment of intercondylar spine(s) and/or tuberosity fracture(s) of knee, with or without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35889.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KF","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86344","name":"Leukocyte phagocytosis","description":"Leukocyte phagocytosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97167","name":"Ot eval high complex 60 min","description":"Occupational therapy evaluation, high complexity, requiring these components: an occupational profile and medical and therapy history, which includes review of medical and/or therapy records and extensive additional review of physical, cognitive, or psychosocial history related to current functional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62148","name":"Retr bone flap to fix skull","description":"Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45114","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; abdominal and transsacral approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1526.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15152","name":"Tis cltr skn agrft t/a/l ea","description":"Tissue cultured skin autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38214","name":"Volume deplete of harvest","description":"Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61860","name":"Implant neuroelectrodes","description":"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26755","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93640","name":"Ep eval 1/2chmbr pacg cvdfb","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88334","name":"Path consltj surg cyto xm ea","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99255","name":"Ip/obs consltj new/est hi 80","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 80 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62268","name":"Drain spinal cord cyst","description":"Percutaneous aspiration, spinal cord cyst or syrinx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33271","name":"Insj subq impltbl dfb elctrd","description":"Insertion of subcutaneous implantable defibrillator electrode","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23334","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":899.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45327","name":"Proctosigmoidoscopy w/stent","description":"Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36215","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96523","name":"Irrig drug delivery device","description":"Irrigation of implanted venous access device for drug delivery systems","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10368.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99403","name":"Prev med cnsl indiv apprx 45","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53000","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83069","name":"Hemoglobin urine","description":"Hemoglobin; urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76506","name":"Echo exam of head","description":"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0245","name":"Initial foot exam pt lops","description":"Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47141","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments ii, iii and iv)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3592.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"Psych diag eval w/med srvcs","description":"Psychiatric diagnostic evaluation with medical services","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86694","name":"Herpes simplex nes antbdy","description":"Antibody; herpes simplex, non-specific type test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32421","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73202","name":"Ct uppr extremity w/o&w/dye","description":"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54690","name":"Laparoscopy orchiectomy","description":"Laparoscopy, surgical; orchiectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23650","name":"Cltx sho dslc w/mnpj wo anes","description":"Closed treatment of shoulder dislocation, with manipulation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98967","name":"Ph1 assmt&mgmt nqhp 11-20","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22845","name":"Insert spine fixation device","description":"Anterior instrumentation; 2 to 3 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86331","name":"Immunodiffusion ouchterlony","description":"Immunodiffusion; gel diffusion, qualitative (ouchterlony), each antigen or antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64787","name":"Implant nerve end","description":"Implantation of nerve end into bone or muscle (list separately in addition to neuroma excision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00792","name":"Anes iper upr abd prtl hptc","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; partial hepatectomy or management of liver hemorrhage (excluding liver biopsy)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29874","name":"Arthrs knee surg rmv loos/fb","description":"Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0353T","name":"Intraop oct breast cavity","description":"Optical coherence tomography of breast, surgical cavity; real-time intraoperative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78270","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21615","name":"Excision 1st &/cervical rib","description":"Excision first and/or cervical rib;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47563","name":"Laparo cholecystectomy/graph","description":"Laparoscopy, surgical; cholecystectomy with cholangiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25020","name":"Decompress forearm 1 space","description":"Decompression fasciotomy, forearm and/or wrist, flexor or extensor compartment; without debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3350.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26502","name":"Hand tendon reconstruction","description":"Reconstruction of tendon pulley, each tendon; with tendon or fascial graft (includes obtaining graft) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82175","name":"Assay of arsenic","description":"Arsenic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92565","name":"Stenger test pure tone","description":"Stenger test, pure tone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44603","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1341.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41155","name":"Tongue jaw & neck surgery","description":"Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and radical neck dissection (commando type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2332.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0221T","name":"Plmt post facet implt lumb","description":"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95923","name":"Autonomic nrv syst funj test","description":"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32201","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15731","name":"Forehead flap w/vasc pedicle","description":"Forehead flap with preservation of vascular pedicle (eg, axial pattern flap, paramedian forehead flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51535","name":"Repair of ureter lesion","description":"Cystotomy for excision, incision, or repair of ureterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27630","name":"Removal of tendon lesion","description":"Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4189.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1828.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86243","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2058","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4110.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9131.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91105","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29876","name":"Arthrs knee surg synvct maj","description":"Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35889.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44700","name":"Suspend bowel w/prosthesis","description":"Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg, bladder or omentum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57335","name":"Repair vagina","description":"Vaginoplasty for intersex state","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31624","name":"Dx bronchoscope/lavage","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86705","name":"Hep b core antibody igm","description":"Hepatitis b core antibody (hbcab); igm antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95904","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26479","name":"Shortening of hand tendon","description":"Shortening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67440","name":"Explore/drain eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35476","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85576","name":"Blood platelet aggregation","description":"Platelet, aggregation (in vitro), each agent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11401","name":"Exc tr-ext b9+marg 0.6-1 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4589.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87420","name":"Resp syncytial virus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; respiratory syncytial virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","name":"Anes open/arthr ntrthrc amp","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; interthoracoscapular (forequarter) amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","name":"Anes xtnsv sp&spi cord px","description":"Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50526","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1384.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":491.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87190","name":"Sc std myobacteria prop meth","description":"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4224.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25295","name":"Release wrist/forearm tendon","description":"Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7534.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41510","name":"Tongue to lip surgery","description":"Suture of tongue to lip for micrognathia (douglas type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3822.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33995","name":"Insj perq vad r hrt venous","description":"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; right heart, venous access only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99283","name":"Emergency dept visit low mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23920","name":"Disarticulation shoulder","description":"Disarticulation of shoulder;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4808.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95982","name":"Io ga n-stim subsq w/reprog","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24006","name":"Arthrt elbw capsl exc rls","description":"Arthrotomy of the elbow, with capsular excision for capsular release (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73723","name":"Mri joint lwr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42960","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6000","name":"Wound warming wound cover","description":"Non-contact wound warming wound cover for use with the non-contact wound warming device and warming card","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84392","name":"Assay of urine sulfate","description":"Sulfate, urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1632.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36595","name":"Mech remov tunneled cv cath","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64885","name":"Nerve graft head/neck <4 cm","description":"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78461","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58670","name":"Laparoscopy tubal cautery","description":"Laparoscopy, surgical; with fulguration of oviducts (with or without transection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78801","name":"Rp loclzj tum 2+area 1+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or m","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27250","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01484","name":"Anes opn lw l/a/f oste/ostpl","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95718","name":"Eeg phys/qhp 2-12 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2-12 hours of eeg recording; with video (veeg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92614","name":"Laryngoscopic sensory vid","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33820","name":"Repair pda by ligation","description":"Repair of patent ductus arteriosus; by ligation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75558","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74022","name":"Radex compl aqt abd series","description":"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64766","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4247","name":"Betadine/iodine swabs/wipes","description":"Betadine or iodine swabs/wipes, per box","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78270","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58960","name":"Exploration of abdomen","description":"Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diaphragmatic assessment with pelvic and limited para-aortic lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76886","name":"Us exam infant hips static","description":"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51990","name":"Laparo urethral suspension","description":"Laparoscopy, surgical; urethral suspension for stress incontinence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20561","name":"Ndl insj w/o njx 3+ musc","description":"Needle insertion(s) without injection(s); 3 or more muscles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45398","name":"Colonoscopy w/band ligation","description":"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57465","name":"Cam cervix uteri drg colp","description":"Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35512","name":"Art byp grft subclav-brchial","description":"Bypass graft, with vein; subclavian-brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49083","name":"Abd paracentesis w/imaging","description":"Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34501","name":"Repair valve femoral vein","description":"Valvuloplasty, femoral vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99416","name":"Prolng clin staff svc ea add","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (list separately in addition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24310","name":"Tnot opn elbw to sho ea tdn","description":"Tenotomy, open, elbow to shoulder, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96450","name":"Chemotherapy into cns","description":"Chemotherapy administration, into cns (eg, intrathecal), requiring and including spinal puncture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89051","name":"Body fluid cell count","description":"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80201","name":"Assay of topiramate","description":"Topiramate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92060","name":"Sensorimotor examination","description":"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3790.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45381","name":"Colonoscopy submucous njx","description":"Colonoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27511","name":"Treatment of thigh fracture","description":"Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61607","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2313.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25545","name":"Optx ulnar shft fx int fixj","description":"Open treatment of ulnar shaft fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33959","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1464.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43283","name":"Lap esoph lengthening","description":"Laparoscopy, surgical, esophageal lengthening procedure (eg, collis gastroplasty or wedge gastroplasty) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50650","name":"Removal of ureter","description":"Ureterectomy, with bladder cuff (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44145","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99309","name":"Sbsq nf care moderate mdm 30","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40527","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with cross lip flap (abbe-estlander)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82672","name":"Assay of estrogen","description":"Estrogens; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1597.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98941","name":"Chiropract manj 3-4 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 3-4 regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64451","name":"Njx aa&/strd nrv nrvtg si jt","description":"Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69603","name":"Revj mstdc rsltg rad mstdc","description":"Revision mastoidectomy; resulting in radical mastoidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90885","name":"Psy evaluation of records","description":"Psychiatric evaluation of hospital records, other psychiatric reports, psychometric and/or projective tests, and other accumulated data for medical diagnostic purposes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42804","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, visible lesion, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90952","name":"Esrd serv 2-3 vsts p mo <2yr","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12031","name":"Intmd rpr s/a/t/ext 2.5 cm/<","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0245","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31637","name":"Bronchoscopy stent add-on","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; each additional major bronchus stented (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2800.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80188","name":"Assay of primidone","description":"Primidone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95972","name":"Alys cplx sp/pn npgt w/prgrm","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46615","name":"Anoscopy","description":"Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15331","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82978","name":"Assay of glutathione","description":"Glutathione","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49436","name":"Embedded ip cath exit-site","description":"Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84135","name":"Assay of pregnanediol","description":"Pregnanediol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33991","name":"Insj perq vad l hrt artl&ven","description":"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, both arterial and venous access, with transseptal puncture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92082","name":"Intermediate visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on goldmann perimeter, or semiquantitative, automated suprathreshold screening program, humphrey suprathreshold automatic diagnostic test, octopus program 33)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49496","name":"Rpr ing hernia baby blocked","description":"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3846.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":7300.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89321","name":"Semen anal sperm detection","description":"Semen analysis; sperm presence and motility of sperm, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6405.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51575","name":"Removal of bladder & nodes","description":"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1476.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21139","name":"Rdctj forehead cntrg&setback","description":"Reduction forehead; contouring and setback of anterior frontal sinus wall","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35470","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86750","name":"Malaria antibody","description":"Antibody; plasmodium (malaria)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31051","name":"Sphenoid sinus surgery","description":"Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78835","name":"Rp quan meas single area","description":"Radiopharmaceutical quantification measurement(s) single area (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23120","name":"Claviculectomy partial","description":"Claviculectomy; partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86787","name":"Varicella-zoster antibody","description":"Antibody; varicella-zoster","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51728","name":"Cystometrogram w/vp","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":653.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93228","name":"Remote 30 day ecg rev/report","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19357","name":"Tiss xpndr plmt brst rcnstj","description":"Tissue expander placement in breast reconstruction, including subsequent expansion(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":964.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97024","name":"Diathermy eg microwave","description":"Application of a modality to 1 or more areas; diathermy (eg, microwave)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43820","name":"Gastrojejunostomy wo vagotmy","description":"Gastrojejunostomy; without vagotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74340","name":"X-ray guide for gi tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott), including multiple fluoroscopies and images, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6240.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47554","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with removal of calculus/calculi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90461","name":"Im admin each addl component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87186","name":"Sc std microdil/agar dil","description":"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [mic] or breakpoint), each multi-antimicrobial, per plate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80432","name":"Insulin suppression panel","description":"Insulin-induced c-peptide suppression panel this panel must include the following: insulin (83525) c-peptide (84681 x 5) glucose (82947 x 5)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33215","name":"Reposition pacing-defib lead","description":"Repositioning of previously implanted transvenous pacemaker or implantable defibrillator (right atrial or right ventricular) electrode","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31648","name":"Bronchial valve remov init","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), initial lobe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0366","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93720","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95939","name":"C motor evoked upr&lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50045","name":"Nephrotomy w/exploration","description":"Nephrotomy, with exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419T","name":"Dstrj neurofibroma xtnsv","description":"Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); face, head and neck, greater than 50 neurofibromas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95833","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1510","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56740","name":"Exc bartholins gland/cyst","description":"Excision of bartholins gland or cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96158","name":"Hlth bhv ivntj indiv 1st 30","description":"Health behavior intervention, individual, face-to-face; initial 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86860","name":"Rbc antibody elution","description":"Antibody elution (rbc), each elution","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34825","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70373","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97537","name":"Community/work reintegration","description":"Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or work environment/modification analysis, work task analysis, use of assistive technology device/adaptive equipment), direct one-on-one contact, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36906","name":"Thrmbc/nfs dialysis circuit","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thromboly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4261","name":"Cervical cap contraceptive","description":"Cervical cap for contraceptive use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12044","name":"Intmd rpr n-hf/genit7.6-12.5","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97810","name":"Acup 1/> wo estim 1st 15 min","description":"Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32900","name":"Removal of rib(s)","description":"Resection of ribs, extrapleural, all stages","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22556","name":"Arthrd ant ntrbd min dsc thc","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1467.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28190","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; subcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84105","name":"Assay of urine phosphorus","description":"Phosphorus inorganic (phosphate); urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11043","name":"Dbrdmt musc&/fsca 1st 20/<","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21422","name":"Optx palatal/max fracture","description":"Open treatment of palatal or maxillary fracture (lefort i type);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8227.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11721","name":"Debride nail 6 or more","description":"Debridement of nail(s) by any method(s); 6 or more","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44156","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, with proctectomy; with continent ileostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1935.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4081","name":"Enteral ng tubing w/ stylet","description":"Nasogastric tubing with stylet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25025","name":"Decompress forearm 2 spaces","description":"Decompression fasciotomy, forearm and/or wrist, flexor and extensor compartment; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1016.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2023","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0508","name":"Crit care telehea consult 60","description":"Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87143","name":"Culture typing glc/hplc","description":"Culture, typing; gas liquid chromatography (glc) or high pressure liquid chromatography (hplc) method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50060","name":"Nl removal calculus","description":"Nephrolithotomy; removal of calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92226","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66830","name":"Removal of lens lesion","description":"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0507","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84061","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69705","name":"Nps surg dilat eust tube uni","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15922","name":"Exc coccygl pr ulc flap clsr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with flap closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33244","name":"Remove elctrd transvenously","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81050","name":"Urinalysis volume measure","description":"Volume measurement for timed collection, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8053.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64577","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87803","name":"Clostridium toxin a w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; clostridium difficile toxin a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25250","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40654","name":"Rpr lip fth>1half ver ht/cpx","description":"Repair lip, full thickness; over one-half vertical height, or complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42660","name":"Dilation of salivary duct","description":"Dilation and catheterization of salivary duct, with or without injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01520","name":"Anes px veins lower leg nos","description":"Anesthesia for procedures on veins of lower leg; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4521","name":"Adult size brief/diaper sm","description":"Adult sized disposable incontinence product, brief/diaper, small, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30460","name":"Revision of nose","description":"Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86793","name":"Yersinia antibody","description":"Antibody; yersinia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49441","name":"Place duod/jej tube perc","description":"Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21395","name":"Opn tx orbit periorbt w/grft","description":"Open treatment of orbital floor blowout fracture; periorbital approach with bone graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72147","name":"Mri chest spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26735","name":"Treat finger fracture each","description":"Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation, when performed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38308","name":"Incision of lymph channels","description":"Lymphangiotomy or other operations on lymphatic channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","name":"Anes dx/ther nrv blk&inj prn","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95149","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 5 single stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43400","name":"Ligate esophagus veins","description":"Ligation, direct, esophageal varices","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1277.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1341.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5646.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0216T","name":"Njx paravert w/us lumb/sac","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51565","name":"Revise bladder & ureter(s)","description":"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93016","name":"Cv stress test supvj only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91012","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57505","name":"Endocervical curettage","description":"Endocervical curettage (not done as part of a dilation and curettage)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22116","name":"Remove extra spine segment","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10021","name":"Fna bx w/o img gdn 1st les","description":"Fine needle aspiration biopsy, without imaging guidance; first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58260","name":"Vaginal hysterectomy","description":"Vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43238","name":"Egd us fine needle bx/aspir","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31630","name":"Bronchoscopy dilate/fx repr","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with tracheal/bronchial dilation or closed reduction of fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32124","name":"Explore chest free adhesions","description":"Thoracotomy; with open intrapleural pneumonolysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87451","name":"Polyvalent mult org ea ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; polyvalent for multiple organisms, each polyvalent antiserum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43752","name":"Nasal/orogastric w/tube plmt","description":"Naso- or oro-gastric tube placement, requiring physicians skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93279","name":"Prgrmg dev eval pm/ldls pm","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system or","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6118.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86890","name":"Autologous blood process","description":"Autologous blood or component, collection processing and storage; predeposited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":734.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78272","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54231","name":"Dynamic cavernosometry","description":"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35509","name":"Art byp grft contral carotid","description":"Bypass graft, with vein; carotid-contralateral carotid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93280","name":"Pm device progr eval dual","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":57.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95836","name":"Ecog impltd brn npgt <30 d","description":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter, including recording, with interpretation and written report, up to 30 days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64646","name":"Chemodenerv trunk musc 1-5","description":"Chemodenervation of trunk muscle(s); 1-5 muscle(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99406","name":"Behav chng smoking 3-10 min","description":"Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99082","name":"Unusual physician travel","description":"Unusual travel (eg, transportation and escort of patient)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23600","name":"Cltx prox humrl fx w/o mnpj","description":"Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","name":"Anes opn lwr l/a/f rad rescj","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22527","name":"Idet 1 or more levels","description":"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; 1 or more additional levels (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21720","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; without cast application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88148","name":"Cytopath c/v auto rescreen","description":"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3752.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"Immunization admin each add","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26910","name":"Amputate metacarpal bone","description":"Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without interosseous transfer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43634","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with formation of intestinal pouch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1788.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24420","name":"Osteoplasty humerus","description":"Osteoplasty, humerus (eg, shortening or lengthening) (excluding 64876)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20975","name":"Estim aid bone healg invasiv","description":"Electrical stimulation to aid bone healing; invasive (operative)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","name":"Anes lwr intst ndsc nos","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32506","name":"Wedge resect of lung add-on","description":"Thoracotomy; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90660","name":"Laiv3 vaccine intranasal","description":"Influenza virus vaccine, trivalent, live (laiv3), for intranasal use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64774","name":"Remove skin nerve lesion","description":"Excision of neuroma; cutaneous nerve, surgically identifiable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78459","name":"Myocrd img pet single study","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30320","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; by lateral rhinotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86720","name":"Leptospira antibody","description":"Antibody; leptospira","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82075","name":"Assay of breath ethanol","description":"Alcohol (ethanol); breath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52630","name":"Remove prostate regrowth","description":"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12016","name":"Rpr fe/e/en/l/m 12.6-20.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29847","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; internal fixation for fracture or instability","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64626","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51798","name":"Us urine capacity measure","description":"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4207","name":"2 cc sterile syringe&needle","description":"Syringe with needle, sterile 2 cc, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58350","name":"Reopen fallopian tube","description":"Chromotubation of oviduct, including materials","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27303","name":"Drainage of bone lesion","description":"Incision, deep, with opening of bone cortex, femur or knee (eg, osteomyelitis or bone abscess)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77079","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36262","name":"Removal of infusion pump","description":"Removal of implanted intra-arterial infusion pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31656","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73723","name":"Mri joint lwr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59409","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11183.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21245","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28238","name":"Revision of foot tendon","description":"Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (eg, kidner type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58152","name":"Total hysterectomy","description":"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, marshall-marchetti-krantz, burch)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15570","name":"Skin pedicle flap trunk","description":"Formation of direct or tubed pedicle, with or without transfer; trunk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96158","name":"Hlth bhv ivntj indiv 1st 30","description":"Health behavior intervention, individual, face-to-face; initial 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97169","name":"Athletic trn eval low cmplx","description":"Athletic training evaluation, low complexity, requiring these components: a history and physical activity profile with no comorbidities that affect physical activity; an examination of affected body area and other symptomatic or related systems addressing 1-2 elements from any of the following: body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35091","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1579.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92353","name":"Fit aphakia spectcl multifoc","description":"Fitting of spectacle prosthesis for aphakia; multifocal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72146","name":"Mri chest spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26555","name":"Positional change of finger","description":"Transfer, finger to another position without microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1155.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93591","name":"Perq transcath cls aortic","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5475.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95706","name":"Eeg wo vid 2-12hr intmt mntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, 2-12 hours; with intermittent monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96170","name":"Hlth bhv ivntj fam wo pt 1st","description":"Health behavior intervention, family (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38211","name":"Tumor cell deplete of harvst","description":"Transplant preparation of hematopoietic progenitor cells; tumor cell depletion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11303","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82376","name":"Assay carboxyhb qual","description":"Carboxyhemoglobin; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35671","name":"Bpg pop-tibl/-prnl artery","description":"Bypass graft, with other than vein; popliteal-tibial or -peroneal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90867","name":"Tcranial magn stim tx plan","description":"Therapeutic repetitive transcranial magnetic stimulation (tms) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15341","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27508","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43205","name":"Esophagus endoscopy/ligation","description":"Esophagoscopy, flexible, transoral; with band ligation of esophageal varices","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2005.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67028","name":"Injection eye drug","description":"Intravitreal injection of a pharmacologic agent (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66635","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; optical (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69820","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82705","name":"Fats/lipids feces qual","description":"Fat or lipids, feces; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27048","name":"Exc hip/pelv tum deep < 5 cm","description":"Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52327","name":"Cystoscopy inject material","description":"Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43622","name":"Removal of stomach","description":"Gastrectomy, total; with formation of intestinal pouch, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1946.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50389","name":"Remove renal tube w/fluoro","description":"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52234","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; small bladder tumor(s) (0.5 up to 2.0 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","QB","NU","RR","QF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5008","name":"Hearing screening","description":"Hearing screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":41.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61516","name":"Crnec treph exc cyst sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1710.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8644.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28106","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13152","name":"Cmplx rpr e/n/e/l 2.6-7.5 cm","description":"Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43113","name":"Removal of esophagus","description":"Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3638.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62292","name":"Njx chemonucleolysis lmbr","description":"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8644.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33916","name":"Surgery of great vessel","description":"Pulmonary endarterectomy, with or without embolectomy, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3695.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21198","name":"Reconstr lwr jaw segment","description":"Osteotomy, mandible, segmental;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93279","name":"Prgrmg dev eval pm/ldls pm","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system or","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63066","name":"Decompress spine cord add-on","description":"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E1340","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63200","name":"Release spinal cord lumbar","description":"Laminectomy, with release of tethered spinal cord, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37247","name":"Trluml balo angiop addl art","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90466","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97140","name":"Manual therapy 1/> regions","description":"Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","name":"Anes opn/arthr tot sho rplcm","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0457","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35182","name":"Rpr cgen av fistula thrx&abd","description":"Repair, congenital arteriovenous fistula; thorax and abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1554.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14350","name":"Filleted finger/toe flap","description":"Filleted finger or toe flap, including preparation of recipient site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15430","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73223","name":"Mri joint upr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3216","name":"Orthoped ladies shoes dpth i","description":"Orthopedic footwear, ladies shoe, depth inlay, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82140","name":"Assay of ammonia","description":"Ammonia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93923","name":"Upr/lxtr art stdy 3+ lvls","description":"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional doppler wave","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50951","name":"Endoscopy of ureter","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3207","name":"Hightop w/ supp/pronator jun","description":"Orthopedic shoe, hightop with supinator or pronator, junior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3292.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86481","name":"Tb ag response t-cell susp","description":"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing t-cells in cell suspension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11387.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33774","name":"Rpr tga atrial baffle px","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33335","name":"Insert major vessel graft","description":"Insertion of graft, aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1623.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93641","name":"Ep evl 1/2chmb pac cvdfb tst","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2551.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1367.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33496","name":"Repair prosth valve clot","description":"Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26593","name":"Release muscles of hand","description":"Release, intrinsic muscles of hand, each muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92586","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3257","name":"Orth foot add charge split s","description":"Orthopedic footwear, additional charge for split size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52341","name":"Cysto w/ureter stricture tx","description":"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29838","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, extensive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12016","name":"Rpr fe/e/en/l/m 12.6-20.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5947.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31800","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27001","name":"Tenotomy adductor hip open","description":"Tenotomy, adductor of hip, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1383.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78808","name":"Iv inj ra drug dx study","description":"Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid adenoma)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3461.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52005","name":"Cysto w/urtrl cathj","description":"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44316","name":"Devise bowel pouch","description":"Continent ileostomy (kock procedure) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1186.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38205","name":"Harvest allogeneic stem cell","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23184","name":"Prtl excision bone prox hum","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), proximal humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85810","name":"Blood viscosity examination","description":"Viscosity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96004","name":"Phys review of motion tests","description":"Review and interpretation by physician or other qualified health care professional of comprehensive computer-based motion analysis, dynamic plantar pressure measurements, dynamic surface electromyography during walking or other functional activities, and dynamic fine wire electromyography, with writ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86038","name":"Antinuclear antibodies","description":"Antinuclear antibodies (ana);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13100","name":"Cmplx rpr trunk 1.1-2.5 cm","description":"Repair, complex, trunk; 1.1 cm to 2.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78830","name":"Rp loclzj tum spect w/ct 1","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67346","name":"Biopsy eye muscle","description":"Biopsy of extraocular muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13153","name":"Cmplx rpr e/n/e/l addl 5cm/<","description":"Repair, complex, eyelids, nose, ears and/or lips; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27429","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56805","name":"Clitoroplasty intersex state","description":"Clitoroplasty for intersex state","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70481","name":"Ct orbit/ear/fossa w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KC","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43772","name":"Lap rmvl gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28490","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1481.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":780.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64642","name":"Chemodenerv 1 extremity 1-4","description":"Chemodenervation of one extremity; 1-4 muscle(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36456","name":"Prtl exchange transfuse nb","description":"Partial exchange transfusion, blood, plasma or crystalloid necessitating the skill of a physician or other qualified health care professional, newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82373","name":"Assay c-d transfer measure","description":"Carbohydrate deficient transferrin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3368.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80299","name":"Quantitative assay drug","description":"Quantitation of therapeutic drug, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27437","name":"Revise kneecap","description":"Arthroplasty, patella; without prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82160","name":"Assay of androsterone","description":"Androsterone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4158.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","name":"Anes px art lower leg nos","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29200","name":"Strapping thorax","description":"Strapping; thorax","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64708","name":"Revise arm/leg nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24685","name":"Optx ulnar fx prox end w/fix","description":"Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]), includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47145","name":"Prep donor liver lobe split","description":"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with lobe spli","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95970","name":"Alys npgt w/o prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34510","name":"Transposition of vein valve","description":"Venous valve transposition, any vein donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77334","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87040","name":"Blood culture for bacteria","description":"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485T","name":"Oct mid ear i&r unilateral","description":"Optical coherence tomography (oct) of middle ear, with interpretation and report; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35860","name":"Explore limb vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","name":"Anes px art knee&pop exc&grf","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64400","name":"Njx aa&/strd trigeminal nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49655","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2054.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20610","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33210","name":"Insert electrd/pm cath sngl","description":"Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11406","name":"Exc tr-ext b9+marg >4.0 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42509","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with excision of both submandibular glands","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99291","name":"Critical care first hour","description":"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24346","name":"Reconstruct elbow med ligmnt","description":"Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25031","name":"I&d forearm&/wrist bursa","description":"Incision and drainage, forearm and/or wrist; bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31546","name":"Remove vc lesion scope/graft","description":"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with graft(s) (includes obtaining autograft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93280","name":"Pm device progr eval dual","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33960","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25500","name":"Cltx rdl shft fx w/o mnpj","description":"Closed treatment of radial shaft fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33120","name":"Exc icar tum resc w/card byp","description":"Excision of intracardiac tumor, resection with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1821.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75959","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9157","name":"Transesoph doppl cardiac mon","description":"Transesophageal doppler measurement of cardiac output (including probe placement, image acquisition, and interpretation per course of treatment) for monitoring purposes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27407","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; cruciate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50430","name":"Njx px nfrosgrm &/urtrgrm","description":"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3209","name":"Surgical boot each child","description":"Surgical boot, each, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98925","name":"Osteopath manj 1-2 regions","description":"Osteopathic manipulative treatment (omt); 1-2 body regions involved","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21199","name":"Reconstr lwr jaw w/advance","description":"Osteotomy, mandible, segmental; with genioglossus advancement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96567","name":"Pdt dstr prmlg les skn","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33866","name":"Aortic hemiarch graft","description":"Aortic hemiarch graft including isolation and control of the arch vessels, beveled open distal aortic anastomosis extending under one or more of the arch vessels, and total circulatory arrest or isolated cerebral perfusion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93312","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0502","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22864","name":"Rmvl tot arthrp 1ntrspc crv","description":"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1893.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","name":"Anes px art knee&pop exc&grf","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78710","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29580","name":"Strapping unna boot","description":"Strapping; unna boot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1730","name":"Cath, ep, 19 or few elect","description":"Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86886","name":"Coombs test indirect titer","description":"Antihuman globulin test (coombs test); indirect, each antibody titer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4523","name":"Adult size brief/diaper lg","description":"Adult sized disposable incontinence product, brief/diaper, large, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43271","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88332","name":"Path consltj surg ea add blk","description":"Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP08","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","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, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1907.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1911.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546T","name":"Rf spectrsc ntraop mrgn asmt","description":"Radiofrequency spectroscopy, real time, intraoperative margin assessment, at the time of partial mastectomy, with report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36013","name":"Place catheter in artery","description":"Introduction of catheter, right heart or main pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74270","name":"X-ray xm colon 1cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82820","name":"Hemoglobin-oxygen affinity","description":"Hemoglobin-oxygen affinity (po2 for 50% hemoglobin saturation with oxygen)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43283","name":"Lap esoph lengthening","description":"Laparoscopy, surgical, esophageal lengthening procedure (eg, collis gastroplasty or wedge gastroplasty) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87591","name":"N.gonorrhoeae dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24498","name":"Proph tx w/wo mthylmthcrylt","description":"Prophylactic treatment (nailing, pinning, plating or wiring), with or without methylmethacrylate, humeral shaft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35563","name":"Art byp grft ilioiliac","description":"Bypass graft, with vein; ilioiliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39402","name":"Mediastinoscpy w/lmph nod bx","description":"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48500","name":"Surgery of pancreatic cyst","description":"Marsupialization of pancreatic cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66605","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; with cyclectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64491","name":"Inj paravert f jnt c/t 2 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66984","name":"Xcapsl ctrc rmvl w/o ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45910","name":"Dilation of rectal narrowing","description":"Dilation of rectal stricture (separate procedure) under anesthesia other than local","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2147.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7929.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43600","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44361","name":"Small bowel endoscopy/biopsy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84436","name":"Assay of total thyroxine","description":"Thyroxine; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37761","name":"Ligate leg veins open","description":"Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97530","name":"Therapeutic activities","description":"Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29510.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15131","name":"Drm agrft t/a/l ea addl","description":"Dermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84446","name":"Assay of vitamin e","description":"Tocopherol alpha (vitamin e)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3603.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31587","name":"Laryngoplasty cricoid split","description":"Laryngoplasty, cricoid split, without graft placement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75662","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15771","name":"Grfg autol fat lipo 50 cc/<","description":"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78266","name":"Gstr empt img sm bwl&colon","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0237T","name":"Trluml perip athrc brchiocph","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; brachiocephalic trunk and branches, each vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9507.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68360","name":"Revise eyelid lining","description":"Conjunctival flap; bridge or partial (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92014","name":"Compre oph exam est pt 1/>","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31500","name":"Insert emergency airway","description":"Intubation, endotracheal, emergency procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25490","name":"Prophylactic tx radius","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5225.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6017","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81178","name":"Atxn1 gene detc abnor allele","description":"Atxn1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":338.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45345","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35141","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, common femoral artery (profunda femoris, superficial femoral)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17273","name":"Dstr mal les s/n/h/f/g 2.1-3","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E1340","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3206","name":"Hightop w/ supp/pronator chi","description":"Orthopedic shoe, hightop with supinator or pronator, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61682","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4018.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93312","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50545","name":"Laparo radical nephrectomy","description":"Laparoscopy, surgical; radical nephrectomy (includes removal of gerotas fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63664","name":"Revise spine eltrd plate","description":"Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91010","name":"Esophagus motility study","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86341","name":"Islet cell antibody","description":"Islet cell antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59857","name":"Induced ab 1+vag supp hyst","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed medical evacuation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47460","name":"Incise bile duct sphincter","description":"Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65815","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU","59"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28171","name":"Resect tarsal tumor","description":"Radical resection of tumor; tarsal (except talus or calcaneus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27077","name":"Resect hip tum w/innom bone","description":"Radical resection of tumor; innominate bone, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2404.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6391.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74246","name":"X-ray xm upr gi trc 2cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87525","name":"Hepatitis g dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56630","name":"Vulvectomy radical partial","description":"Vulvectomy, radical, partial;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75995","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99153","name":"Mod sed same phys/qhp ea","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9487","name":"Remote e/m est. pt 15mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54416","name":"Remv/repl penis contain pros","description":"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53854","name":"Trurl dstrj prst8 tiss rf wv","description":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59136","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21346","name":"Opn tx nasomax fx w/fixj","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); with wiring and/or local fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61305","name":"Crnec/crnot expl infratntorl","description":"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72197","name":"Mri pelvis w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96417","name":"Chemo iv infus each addl seq","description":"Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4158.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25675","name":"Cltx dstl rad/uln dislc mnpj","description":"Closed treatment of distal radioulnar dislocation with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97813","name":"Acup 1/> w/estim 1st 15 min","description":"Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1848.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61868","name":"Implant neuroelectrde addl","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; each additional ar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26121","name":"Release palm contracture","description":"Fasciectomy, palm only, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28313","name":"Repair deformity of toe","description":"Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28555","name":"Repair foot dislocation","description":"Open treatment of tarsal bone dislocation, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93875","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1416.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22315","name":"Closed tx vert fx w/manj","description":"Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting or bracing, with and including casting and/or bracing by manipulation or traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27614","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92608","name":"Ex for speech device rx addl","description":"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11440","name":"Exc face-mm b9+marg 0.5 cm/<","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82731","name":"Assay of fetal fibronectin","description":"Fetal fibronectin, cervicovaginal secretions, semi-quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11403","name":"Exc tr-ext b9+marg 2.1-3cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","name":"Anes all px neck nos 1yr/>","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75561","name":"Cardiac mri for morph w/dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28430","name":"Cltx talus fracture w/o mnpj","description":"Closed treatment of talus fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93325","name":"Doppler echo color flow mapg","description":"Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82306","name":"Vitamin d 25 hydroxy","description":"Vitamin d; 25 hydroxy, includes fraction(s), if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82380","name":"Assay of carotene","description":"Carotene","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44382","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76814","name":"Ob us nuchal meas add-on","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4709","name":"Acid conc sol per gallon","description":"Acid concentrate, solution, for hemodialysis, per gallon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1922.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25622","name":"Cltx carpl scphd fx w/o mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71551","name":"Mri chest w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33845","name":"Excision coa w/graft","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1154.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0121","name":"Colon ca scrn not hi rsk ind","description":"Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28800","name":"Amputation of midfoot","description":"Amputation, foot; midtarsal (eg, chopart type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32855","name":"Prepare donor lung single","description":"Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63075","name":"Neck spine disk surgery","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34520","name":"Cross-over vein graft","description":"Cross-over vein graft to venous system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86485","name":"Skin test candida","description":"Skin test; candida","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"Electrocardiogram complete","description":"Electrocardiogram, routine ecg with at least 12 leads; with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","name":"Anes px vn upr arm&elbw nos","description":"Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1429.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26471","name":"Fusion of finger tendons","description":"Tenodesis; of proximal interphalangeal joint, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24110","name":"Exc/curtg b1 cst/b9 tum hum","description":"Excision or curettage of bone cyst or benign tumor, humerus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5160.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1759.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20240","name":"Bone biopsy open superficial","description":"Biopsy, bone, open; superficial (eg, sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93461","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, cath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1450.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31511","name":"Remove foreign body larynx","description":"Laryngoscopy, indirect; with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","name":"Neuraxl lbr anes vag dlvr","description":"Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":964.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51101","name":"Drain bladder by trocar/cath","description":"Aspiration of bladder; by trocar or intracatheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61583","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2595.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50740","name":"Fusion of ureter & kidney","description":"Ureteropyelostomy, anastomosis of ureter and renal pelvis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73706","name":"Ct angio lwr extr w/o&w/dye","description":"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26100","name":"Biopsy hand joint lining","description":"Arthrotomy with biopsy; carpometacarpal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87254","name":"Virus inoculation shell via","description":"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51101","name":"Drain bladder by trocar/cath","description":"Aspiration of bladder; by trocar or intracatheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1267.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54230","name":"Njx corpora cavernosograpy","description":"Injection procedure for corpora cavernosography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","name":"Anes male gent compl amp pns","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); complete amputation of penis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30630","name":"Repair nasal septum defect","description":"Repair nasal septal perforations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63056","name":"Decompress spinal cord lmbr","description":"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal approach) (eg, far lateral herniated intervertebral disc)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1324.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92082","name":"Intermediate visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on goldmann perimeter, or semiquantitative, automated suprathreshold screening program, humphrey suprathreshold automatic diagnostic test, octopus program 33)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77373","name":"Strtctc bdy rad ther tx dlvr","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":976.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64712","name":"Revision of sciatic nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2970.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01931","name":"Anes ivnt rad ntrhpt/prt crc","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrahepatic or portal circulation (eg, transvenous intrahepatic portosystemic shunt[s] [tips])","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86808","name":"Cytotoxic antibody screening","description":"Serum screening for cytotoxic percent reactive antibody (pra); quick method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64417","name":"Njx aa&/strd ax nerve img","description":"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36245","name":"Ins cath abd/l-ext art 1st","description":"Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86702","name":"Hiv-2 antibody","description":"Antibody; hiv-2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93356","name":"Myocrd strain img spckl trck","description":"Myocardial strain imaging using speckle tracking-derived assessment of myocardial mechanics (list separately in addition to codes for echocardiography imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92588","name":"Evoked auditory tst complete","description":"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43843","name":"Gstr rstcv oth/thn v-band","description":"Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1075.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81274","name":"Htt gene charac alleles","description":"Htt (huntingtin) (eg, huntington disease) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86277","name":"Growth hormone antibody","description":"Growth hormone, human (hgh), antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86706","name":"Hep b surface antibody","description":"Hepatitis b surface antibody (hbsab)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7523","name":"Tracheostomy shower protect","description":"Tracheostomy shower protector, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":42.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42962","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87385","name":"Histoplasma capsul ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; histoplasma capsulatum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78431","name":"Myocrd img pet rst&strs ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31636","name":"Bronchoscopy bronch stents","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of bronchial stent(s) (includes tracheal/bronchial dilation as required), initial bronchus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77523","name":"Proton trmt intermediate","description":"Proton treatment delivery; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73725","name":"Mr ang lwr ext w or w/o dye","description":"Magnetic resonance angiography, lower extremity, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82943","name":"Assay of glucagon","description":"Glucagon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78816","name":"Pet image w/ct full body","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28291","name":"Corrj halux rigdus w/implt","description":"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33262","name":"Rmvl& replc pulse gen 1 lead","description":"Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; single lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63035","name":"Lamot dcmprn nrv rt ea addl","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50437","name":"Dilat xst trc new access rcs","description":"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed; including new access into the renal collecting sys","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69637","name":"Rebuild eardrum structures","description":"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [porp], total ossicular replacement prosthesis [torp])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86757","name":"Rickettsia antibody","description":"Antibody; rickettsia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36820","name":"Av fusion/forearm vein","description":"Arteriovenous anastomosis, open; by forearm vein transposition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86361","name":"T cell absolute count","description":"T cells; absolute cd4 count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0109T","name":"Heat quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using heat-pain stimuli to assess small nerve fiber sensation and hyperalgesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76706","name":"Us abdl aorta screen aaa","description":"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (aaa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93655","name":"Icar cath abltj dscrt arrhyt","description":"Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrhythmia (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75952","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562T","name":"Antmc guide 3d print ea addl","description":"Anatomic guide 3d-printed and designed from image data set(s); each additional anatomic guide (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85048","name":"Automated leukocyte count","description":"Blood count; leukocyte (wbc), automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25685","name":"Optx trns-scphprlnr fx dislc","description":"Open treatment of trans-scaphoperilunar type of fracture dislocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44128","name":"Enterectomy cong add-on","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; each additional resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95710","name":"Eeg w/o vid ea 12-26hr cont","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21336","name":"Open tx septal fx w/wo stabj","description":"Open treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26992","name":"Drainage of bone lesion","description":"Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99360","name":"Physician standby services","description":"Standby service, requiring prolonged attendance, each 30 minutes (eg, operative standby, standby for frozen section, for cesarean/high risk delivery, for monitoring eeg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66762","name":"Revision of iris","description":"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45309","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20396.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66761","name":"Revision of iris","description":"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44382","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29916","name":"Hip arthro w/labral repair","description":"Arthroscopy, hip, surgical; with labral repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22901","name":"Exc abdl tum deep 5 cm/>","description":"Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25920","name":"Amputate hand at wrist","description":"Disarticulation through wrist;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93308","name":"Tte f-up or lmtd","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1686.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75680","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25040","name":"Arthrt rdcrpl/midcarpl jt","description":"Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66700","name":"Destruction ciliary body","description":"Ciliary body destruction; diathermy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87480","name":"Candida dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88304","name":"Tissue exam by pathologist","description":"Level iii - surgical pathology, gross and microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque bartholins gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel t","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36589","name":"Removal tunneled cv cath","description":"Removal of tunneled central venous catheter, without subcutaneous port or pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76506","name":"Echo exam of head","description":"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78430","name":"Myocrd img pet rst/strs w/ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43195","name":"Esophagoscopy rigid balloon","description":"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82261","name":"Assay of biotinidase","description":"Biotinidase, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88112","name":"Cytopath cell enhance tech","description":"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93244","name":"Ext ecg>48hr<7d rev&interpj","description":"External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; review and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24145","name":"Prtl exc bone radial h/n","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), radial head or neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25820","name":"Arthrd wrist lmtd w/o b1 grf","description":"Arthrodesis, wrist; limited, without bone graft (eg, intercarpal or radiocarpal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76979","name":"Us trgt dyn mbubb ea addl","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51840","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49010","name":"Exploration behind abdomen","description":"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11444","name":"Exc face-mm b9+marg 3.1-4 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38213","name":"Platelet deplete of harvest","description":"Transplant preparation of hematopoietic progenitor cells; platelet depletion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19086","name":"Bx breast add lesion mr imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including magnetic resonance guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"Immunotherapy injections","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33665","name":"Repair of heart defects","description":"Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1665.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71040","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11603","name":"Exc tr-ext mal+marg 2.1-3 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78267","name":"Urea breath tst c-14 acquisj","description":"Urea breath test, c-14 (isotopic); acquisition for analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00860","name":"Anes xtrprtl px lwr abd nos","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3265","name":"Plastazote sandal each","description":"Plastazote sandal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2554.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S2083","name":"Adjustment gastric band","description":"Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76882","name":"Us lmtd jt/fcl evl nvasc xtr","description":"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87324","name":"Clostridium ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; clostridium difficile toxin(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78265","name":"Gstr emptg img sm bwl trnst","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49495","name":"Rpr ing hernia baby reduc","description":"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4706","name":"Bicarbonate conc sol per gal","description":"Bicarbonate concentrate, solution, for hemodialysis, per gallon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78815","name":"Pet image w/ct skull-thigh","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; skull base to mid-thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77409","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86185","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27390","name":"Incision of thigh tendon","description":"Tenotomy, open, hamstring, knee to hip; single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99473","name":"Self-meas bp pt educaj/train","description":"Self-measured blood pressure using a device validated for clinical accuracy; patient education/training and device calibration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82668","name":"Assay of erythropoietin","description":"Erythropoietin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95065","name":"Dir nsl mucous membrane test","description":"Direct nasal mucous membrane test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31527","name":"Laryngoscopy for treatment","description":"Laryngoscopy direct, with or without tracheoscopy; with insertion of obturator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87526","name":"Hepatitis g dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4215","name":"Sterile needle","description":"Needle, sterile, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26910","name":"Amputate metacarpal bone","description":"Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without interosseous transfer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29860","name":"Hip arthroscopy dx","description":"Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96413","name":"Chemo iv infusion 1 hr","description":"Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6233.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27498","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, multiple compartments;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27437","name":"Revise kneecap","description":"Arthroplasty, patella; without prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64510","name":"N block stellate ganglion","description":"Injection, anesthetic agent; stellate ganglion (cervical sympathetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8505","name":"Artificial larynx, accessory","description":"Artificial larynx replacement battery / accessory, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58940","name":"Removal of ovary(s)","description":"Oophorectomy, partial or total, unilateral or bilateral;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25446","name":"Arthrp w/prostc dst rds&crps","description":"Arthroplasty with prosthetic replacement; distal radius and partial or entire carpus (total wrist)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81305","name":"Myd88 gene p.leu265pro vrnt","description":"Myd88 (myeloid differentiation primary response 88) (eg, waldenstroms macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.leu265pro (l265p) variant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30465","name":"Repair nasal stenosis","description":"Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26650","name":"Treat thumb fracture","description":"Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11786.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75952","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29405","name":"Appl short leg cast","description":"Application of short leg cast (below knee to toes);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45900","name":"Reduction of rectal prolapse","description":"Reduction of procidentia (separate procedure) under anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49611","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); second stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58560","name":"Hysteroscopy resect septum","description":"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95120","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; single injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","name":"Anes nrv msc upr a&e tndsis","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33991","name":"Insj perq vad l hrt artl&ven","description":"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, both arterial and venous access, with transseptal puncture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27618","name":"Exc leg/ankle tum < 3 cm","description":"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36450","name":"Bld exchange truj newborn","description":"Exchange transfusion, blood; newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15271","name":"Skin sub graft trnk/arm/leg","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47534","name":"Plmt biliary drainage cath","description":"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90863","name":"Pharmacologic mgmt w/psytx","description":"Pharmacologic management, including prescription and review of medication, when performed with psychotherapy services (list separately in addition to the code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21011","name":"Exc face les sc <2 cm","description":"Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"Prev visit est age 18-39","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93662","name":"Intracardiac ecg (ice)","description":"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92588","name":"Evoked auditory tst complete","description":"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67320","name":"Revise eye muscle(s) add-on","description":"Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28320","name":"Repair of foot bones","description":"Repair, nonunion or malunion; tarsal bones","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1367.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71275","name":"Ct angiography chest","description":"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35303","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; popliteal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1089.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86711","name":"John cunningham antibody","description":"Antibody; jc (john cunningham) virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31623","name":"Dx bronchoscope/brush","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3296.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43771","name":"Lap revise gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44310","name":"Ileostomy/jejunostomy","description":"Ileostomy or jejunostomy, non-tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63272","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1352.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54322","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, magpi, v-flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12767.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45108","name":"Anorectal myomectomy","description":"Anorectal myomectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29862","name":"Hip arthr0 w/debridement","description":"Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41520","name":"Reconstruction tongue fold","description":"Frenoplasty (surgical revision of frenum, eg, with z-plasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36908","name":"Stent plmt ctr dialysis seg","description":"Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment (list separately in addition to","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33780","name":"Rpr tga rcnstj clsr vsd","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with closure of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2064.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3252","name":"Shoe molded plastazote cust","description":"Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64858","name":"Repair sciatic nerve","description":"Suture of sciatic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"Psytx complex interactive","description":"Interactive complexity (list separately in addition to the code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":121.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24410","name":"Mlt osteot rlgnm imed rd hum","description":"Multiple osteotomies with realignment on intramedullary rod, humeral shaft (sofield type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90807","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86800","name":"Thyroglobulin antibody","description":"Thyroglobulin antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86382","name":"Neutralization test viral","description":"Neutralization test, viral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92596","name":"Ear protector evaluation","description":"Ear protector attenuation measurements","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25065","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP06","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94452","name":"Hast w/i&r phys/qhp","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2479.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1037.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0198T","name":"Ocular blood flow measure","description":"Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71023","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21812","name":"Treatment of rib fracture","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 4-6 ribs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43267","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1382.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50130","name":"Pyelotomy w/removal calculus","description":"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87487","name":"Chlmyd pneum dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55866","name":"Laps surg prst8ect rpbic rad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63663","name":"Revise spine eltrd perq aray","description":"Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87328","name":"Cryptosporidium ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cryptosporidium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74712","name":"Mri fetal sngl/1st gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70496","name":"Ct angiography head","description":"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38570","name":"Laparoscopy lymph node biop","description":"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58294","name":"Vag hyst w/enterocele compl","description":"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33235","name":"Removal pacemaker electrode","description":"Removal of transvenous pacemaker electrode(s); dual lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94777","name":"Ped home apnea mntr rvw i&r","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; review, interpretation and preparation of report only by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21086","name":"Impres&prep auricular prosth","description":"Impression and custom preparation; auricular prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26117","name":"Rad resect hand tumor < 3 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52224","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of minor (less than 0.5 cm) lesion(s) with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37181","name":"Splice spleen/kidney veins","description":"Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2045.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26415","name":"Excision hand/finger tendon","description":"Excision of extensor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84315","name":"Body fluid specific gravity","description":"Specific gravity (except urine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96411","name":"Chemo iv push addl drug","description":"Chemotherapy administration; intravenous, push technique, each additional substance/drug (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","name":"Anes nrv msc upr a&e tnplsty","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19364","name":"Brst rcnstj free flap","description":"Breast reconstruction; with free flap (eg, ftram, diep, siea, gap flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1780.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15341","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44385","name":"Endoscopy of bowel pouch","description":"Endoscopic evaluation of small intestinal pouch (eg, kock pouch, ileal reservoir [s or j]); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63064","name":"Decompress spinal cord thrc","description":"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65436","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with application of chelating agent (eg, edta)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48510","name":"Drain pancreatic pseudocyst","description":"External drainage, pseudocyst of pancreas, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15783","name":"Dermabrasion suprfl any site","description":"Dermabrasion; superficial, any site (eg, tattoo removal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26496","name":"Revise thumb tendon","description":"Opponensplasty; other methods","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33620","name":"Apply r&l pulm art bands","description":"Application of right and left pulmonary artery bands (eg, hybrid approach stage 1)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1435.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88185","name":"Flowcytometry/tc add-on","description":"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (list separately in addition to code for first marker)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67911","name":"Revise eyelid defect","description":"Correction of lid retraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":84.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46615","name":"Anoscopy","description":"Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2150.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3315.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9489","name":"Remote e/m est. pt 40mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved coms innovation center demonstration project, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision makin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63268","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1272.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57160","name":"Insert pessary/other device","description":"Fitting and insertion of pessary or other intravaginal support device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52214","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74363","name":"X-ray bile duct dilation","description":"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35540","name":"Art byp grft aortbifemoral","description":"Bypass graft, with vein; aortobifemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36400","name":"Vnpnxr<3yrs phy/qhp fem/jug","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; femoral or jugular vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","name":"Anes insj penile prosthesis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":400.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58563","name":"Hysteroscopy ablation","description":"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41010","name":"Incision of tongue fold","description":"Incision of lingual frenum (frenotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24655","name":"Cltx rdl head/nck fx w/mnpj","description":"Closed treatment of radial head or neck fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73221","name":"Mri joint upr extrem w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86902","name":"Blood type antigen donor ea","description":"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":268.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33736","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; open heart with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20690","name":"Appl unipln uni ext fixj sys","description":"Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25332","name":"Revise wrist joint","description":"Arthroplasty, wrist, with or without interposition, with or without external or internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95713","name":"Veeg 2-12 hr cont mntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, 2-12 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72130","name":"Ct chest spine w/o & w/dye","description":"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2118.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84146","name":"Assay of prolactin","description":"Prolactin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29058","name":"Appl cast plaster velpeau","description":"Application, cast; plaster velpeau","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66630","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75660","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49215","name":"Excise sacral spine tumor","description":"Excision of presacral or sacrococcygeal tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1824.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17283","name":"Dstr mal ls f/e/e/n/l/m2.1-3","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67210","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75635","name":"Ct angio abdominal arteries","description":"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10121","name":"Inc&rmvl fb subq tiss comp","description":"Incision and removal of foreign body, subcutaneous tissues; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42140","name":"Excision of uvula","description":"Uvulectomy, excision of uvula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82760","name":"Assay of galactose","description":"Galactose","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27641","name":"Partial removal of fibula","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49435","name":"Insert subq exten to ip cath","description":"Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92977","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86777","name":"Toxoplasma antibody","description":"Antibody; toxoplasma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0174T","name":"Cad cxr with interp","description":"Computer-aided detection (cad) (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation and report, with or without digitization of film radiographic images, chest radiograph(s), performed concurrent with primary interpretation (list s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11667.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65222","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, with slit lamp","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63746","name":"Removal of spinal shunt","description":"Removal of entire lumbosubarachnoid shunt system without replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26650","name":"Treat thumb fracture","description":"Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6022","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33410","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with stentless tissue valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2213.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44135","name":"Intestine transplnt cadaver","description":"Intestinal allotransplantation; from cadaver donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26010","name":"Drainage of finger abscess","description":"Drainage of finger abscess; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43334","name":"Transthor diaphrag hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; without implantation of mesh or other prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37238","name":"Open/perq place stent same","description":"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1587.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4947.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26390","name":"Revise hand/finger tendon","description":"Excision flexor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65775","name":"Correction of astigmatism","description":"Corneal wedge resection for correction of surgically induced astigmatism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92228","name":"Img rta detc/mntr ds phy/qhp","description":"Imaging of retina for detection or monitoring of disease; with remote physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36596","name":"Mech remov tunneled cv cath","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92355","name":"Fitg spect lw vis cmpnd lens","description":"Fitting of spectacle mounted low vision aid; telescopic or other compound lens system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12331.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29889","name":"Arthrs aid pcl rpr/agmntj","description":"Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12051","name":"Intmd rpr face/mm 2.5 cm/<","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26080","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1313.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64561","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86757","name":"Rickettsia antibody","description":"Antibody; rickettsia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93279","name":"Prgrmg dev eval pm/ldls pm","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system or","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96133","name":"Nrpsyc tst eval phys/qhp ea","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the pati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44386","name":"Endoscopy bowel pouch/biop","description":"Endoscopic evaluation of small intestinal pouch (eg, kock pouch, ileal reservoir [s or j]); with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97598","name":"Dbrdmt opn wnd addl 20cm/<","description":"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when perform","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12002","name":"Rpr s/n/ax/gen/trnk2.6-7.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28208","name":"Repair of foot tendon","description":"Repair, tendon, extensor, foot; primary or secondary, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24420","name":"Osteoplasty humerus","description":"Osteoplasty, humerus (eg, shortening or lengthening) (excluding 64876)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52010","name":"Cystoscopy & duct catheter","description":"Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86807","name":"Cytotoxic antibody screening","description":"Serum screening for cytotoxic percent reactive antibody (pra); standard method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50572","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87186","name":"Sc std microdil/agar dil","description":"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [mic] or breakpoint), each multi-antimicrobial, per plate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2010","name":"Remot image submit by pt","description":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m ser","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43352","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64907","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; second stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0505","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","name":"Anes clsd px shoulder joint","description":"Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71022","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45560","name":"Repair of rectocele","description":"Repair of rectocele (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64615","name":"Chemodenerv musc migraine","description":"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26992","name":"Drainage of bone lesion","description":"Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25119","name":"Partial removal of ulna","description":"Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27664","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98971","name":"Nqhp ol dig assmt&mgmt 11-20","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65850","name":"Trabeculotomy ab externo","description":"Trabeculotomy ab externo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61522","name":"Removal of brain abscess","description":"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2006.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29907","name":"Subtalar arthro w/fusion","description":"Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60545","name":"Explore adrenal gland","description":"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76881","name":"Us compl joint r-t w/img","description":"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23073","name":"Exc shoulder tum deep 5 cm/>","description":"Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73718","name":"Mri lower extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27355","name":"Remove femur lesion","description":"Excision or curettage of bone cyst or benign tumor of femur;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78594","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28041","name":"Exc foot/toe tum dep 1.5cm/>","description":"Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); 1.5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95852","name":"Range of motion measurements","description":"Range of motion measurements and report (separate procedure); hand, with or without comparison with normal side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93050","name":"Art pressure waveform analys","description":"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity art","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9678","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87252","name":"Virus inoculation tissue","description":"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58671","name":"Laparoscopy tubal block","description":"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or falope ring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43336","name":"Thorabd diaphr hern repair","description":"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; without implantation of mesh or other prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78452","name":"Ht muscle image spect mult","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or red","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53442","name":"Remove/revise male sling","description":"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95920","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24147","name":"Prtl exc bone olecrn process","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28630","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59852","name":"Induced abortion 1+njx hyst","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic injection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84207","name":"Assay of vitamin b-6","description":"Pyridoxal phosphate (vitamin b-6)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29581","name":"Appl multlayer cmprn sys leg","description":"Application of multi-layer compression system; leg (below knee), including ankle and foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70559","name":"Mri brain w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80154","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29582","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21355","name":"Perq tx malar fracture","description":"Percutaneous treatment of fracture of malar area, including zygomatic arch and malar tripod, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24140","name":"Partial exc bone humerus","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37197","name":"Remove intrvas foreign body","description":"Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter), includes radiological supervision and interpretation, and imaging guidance (ultrasound or fluoroscopy), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81233","name":"Btk gene common variants","description":"Btk (brutons tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, c481s, c481r, c481f)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27732","name":"Repair of fibula epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33968","name":"Remove aortic assist device","description":"Removal of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11046","name":"Dbrdmt musc&/fsca ea addl","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36512","name":"Apheresis rbc","description":"Therapeutic apheresis; for red blood cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48001","name":"Placement of drain pancreas","description":"Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1941.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97113","name":"Aquatic therapy/exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87149","name":"Dna/rna direct probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, direct probe technique, per culture or isolate, each organism probed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33361","name":"Replace aortic valve perq","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; percutaneous femoral artery approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92242","name":"Fluorescein&icg angiography","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37207","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95923","name":"Autonomic nrv syst funj test","description":"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35132","name":"Repair artery rupture groin","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, iliac artery (common, hypogastric, external)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2549.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"Tympanometry & reflex thresh","description":"Tympanometry and reflex threshold measurements","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48146","name":"Pancreatectomy","description":"Pancreatectomy, distal, near-total with preservation of duodenum (child-type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43763","name":"Rplc gtube revj gstrst trc","description":"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; requiring revision of gastrostomy tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25248","name":"Remove forearm foreign body","description":"Exploration with removal of deep foreign body, forearm or wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87299","name":"Antibody detection nos if","description":"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24615","name":"Optx aqt/chrnc elbow dislc","description":"Open treatment of acute or chronic elbow dislocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71551","name":"Mri chest w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76950","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41010","name":"Incision of tongue fold","description":"Incision of lingual frenum (frenotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15733","name":"Musc myoq/fscq flp h&n pedcl","description":"Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65105","name":"Remove eye/attach implant","description":"Enucleation of eye; with implant, muscles attached to implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33859","name":"As-aort grf f/ds oth/thn dsj","description":"Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic disease other than dissection (eg, aneurysm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2126.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84112","name":"Eval amniotic fluid protein","description":"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 [pamg-1], placental protein 12 [pp12], alpha-fetoprotein), qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1154.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33647","name":"Repair heart septum defects","description":"Repair of atrial septal defect and ventricular septal defect, with direct or patch closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88121","name":"Cytp urine 3-5 probes cmptr","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22851","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP23","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12208.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","name":"Anes px male gent orchiopexy","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01935","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6009","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51530","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43276","name":"Ercp stent exchange w/dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent exchanged","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66225","name":"Repair/graft eye lesion","description":"Repair of scleral staphyloma with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"Comprehensive hearing test","description":"Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0249T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0432","name":"Eia hiv-1/hiv-2 screen","description":"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0216T","name":"Njx paravert w/us lumb/sac","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2009","name":"Post-d/c h vst ext pt 60 m","description":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatien","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561T","name":"Antmc guide 3d print 1st gd","description":"Anatomic guide 3d-printed and designed from image data set(s); first anatomic guide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46050","name":"I&d perianal abscess supfc","description":"Incision and drainage, perianal abscess, superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11422","name":"Exc h-f-nk-sp b9+marg 1.1-2","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53660","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61595","name":"Transtemporal approach/skull","description":"Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2025.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36455","name":"Bld exchange truj oth thn nb","description":"Exchange transfusion, blood; other than newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54390","name":"Repair penis and bladder","description":"Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23397","name":"Muscle transfers","description":"Muscle transfer, any type, shoulder or upper arm; multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29806","name":"Sho arthrs srg capsulorraphy","description":"Arthroscopy, shoulder, surgical; capsulorrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73223","name":"Mri joint upr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2214","name":"Init/sub psych care m 1st 30","description":"Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58542","name":"Lsh w/t/o ut 250 g or less","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1510.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20933","name":"Hemicrt intrclry algrft prtl","description":"Allograft, includes templating, cutting, placement and internal fixation, when performed; hemicortical intercalary, partial (ie, hemicylindrical) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80102","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29700","name":"Rmvl/bivlv gauntlet boot/cst","description":"Removal or bivalving; gauntlet, boot or body cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69405","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11310","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95700","name":"Eeg cont rec w/vid eeg tech","description":"Electroencephalogram (eeg) continuous recording, with video when performed, setup, patient education, and takedown when performed, administered in person by eeg technologist, minimum of 8 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92538","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59070","name":"Transabdom amnioinfus w/us","description":"Transabdominal amnioinfusion, including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87904","name":"Phenotype dna hiv w/clt add","description":"Infectious agent phenotype analysis by nucleic acid (dna or rna) with drug resistance tissue culture analysis, hiv 1; each additional drug tested (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33272","name":"Rmvl of subq defibrillator","description":"Removal of subcutaneous implantable defibrillator electrode","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92975","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36558","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35500","name":"Harvest vein for bypass","description":"Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61800","name":"Apply srs headframe add-on","description":"Application of stereotactic headframe for stereotactic radiosurgery (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4736.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1352.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90956","name":"Esrd srv 1 visit p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional per month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93790","name":"Ambl bp mntr w/sw i&r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; review with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447T","name":"Rmvl impltbl glucose sensor","description":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63088","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84066","name":"Assay prostate phosphatase","description":"Phosphatase, acid; prostatic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36160","name":"Establish access to aorta","description":"Introduction of needle or intracatheter, aortic, translumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25260","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92004","name":"Compre oph exam new pt 1/>","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99340","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34111","name":"Removal of arm artery clot","description":"Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, by arm incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2010","name":"Remot image submit by pt","description":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m ser","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43267","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86720","name":"Leptospira antibody","description":"Antibody; leptospira","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20606","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35549","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33266","name":"Ablate atria x10sv endo","description":"Endoscopy, surgical; operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure), without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34451","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by abdominal and leg incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93651","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21616","name":"Exc 1st&/crv rib w/sympth","description":"Excision first and/or cervical rib; with sympathectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51701","name":"Insert bladder catheter","description":"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0448T","name":"Remvl insj impltbl gluc sens","description":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor, including system activation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1529.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33987","name":"Artery expos/graft artery","description":"Arterial exposure with creation of graft conduit (eg, chimney graft) to facilitate arterial perfusion for ecmo/ecls (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69960","name":"Release inner ear canal","description":"Decompression internal auditory canal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31613","name":"Tracheostoma revj simple","description":"Tracheostoma revision; simple, without flap rotation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25630","name":"Cltx carpl fx w/o mnpj ea b1","description":"Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); without manipulation, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92520","name":"Laryngeal function studies","description":"Laryngeal function studies (ie, aerodynamic testing and acoustic testing)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22325","name":"Treat spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1284.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24366","name":"Reconstruct head of radius","description":"Arthroplasty, radial head; with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28088","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; extensor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65800","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80053","name":"Comprehen metabolic panel","description":"Comprehensive metabolic panel this panel must include the following: albumin (82040) bilirubin, total (82247) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphatase, alkaline (84075) potassium (84132) protein, total (84155) sodium ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15116","name":"Epdrm agrft f/s/n/h/f/g/m ea","description":"Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96113","name":"Devel tst phys/qhp ea addl","description":"Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19564.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","name":"Anes xtnsv sp&spi cord px","description":"Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31595","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37765","name":"Stab phleb veins xtr 10-20","description":"Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92522","name":"Evaluate speech production","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34714","name":"Opn fem art expos cndt crtj","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92981","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87335","name":"E coli 0157 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; escherichia coli 0157","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1831.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67040","name":"Laser treatment of retina","description":"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50328","name":"Prep renal graft/arterial","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81309","name":"Pik3ca gene trgt seq alys","description":"Pik3ca (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34800","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9432.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95983","name":"Alys brn npgt prgrmg 15 min","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37182","name":"Insert hepatic shunt (tips)","description":"Insertion of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract formation/dilatation, stent placement and all associated imaging guidance and documentation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65426","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43335","name":"Transthor diaphrag hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43237","name":"Endoscopic us exam esoph","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42210","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49062","name":"Drain to peritoneal cavity","description":"Drainage of extraperitoneal lymphocele to peritoneal cavity, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61564","name":"Excision of skull tumor","description":"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2208.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99174","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with remote analysis and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17284","name":"Dstr mal ls f/e/e/n/l/m3.1-4","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66635","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; optical (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69632","name":"Rebuild eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5363","name":"Language screening","description":"Language screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31551","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, younger than 12 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1143.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3615.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33735","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; closed heart (blalock-hanlon type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9612","name":"Catheterize for urine spec","description":"Catheterization for collection of specimen, single patient, all places of service","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52234","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; small bladder tumor(s) (0.5 up to 2.0 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21408","name":"Opn tx orbit fx w/bone grft","description":"Open treatment of fracture of orbit, except blowout; with bone grafting (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5603.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73719","name":"Mri lower extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27282","name":"Arthrodesis symphysis pubis","description":"Arthrodesis, symphysis pubis (including obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1562.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78122","name":"Whl bld volume determination","description":"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"Esrd serv 4 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31626","name":"Bronchoscopy w/markers","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of fiducial markers, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33975","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11305","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84585","name":"Assay of urine vma","description":"Vanillylmandelic acid (vma), urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78804","name":"Rp loclzj tum whbdy 2+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27616","name":"Resect leg/ankle tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of leg or ankle area; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1087.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33227","name":"Remove&replace pm gen singl","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27071","name":"Part removal hip bone deep","description":"Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0180","name":"Md certification hha patient","description":"Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66710","name":"Ciliary transsleral therapy","description":"Ciliary body destruction; cyclophotocoagulation, transscleral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82131","name":"Amino acids single quant","description":"Amino acids; single, quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55860","name":"Surgical exposure prostate","description":"Exposure of prostate, any approach, for insertion of radioactive substance;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92970","name":"Cardioassist internal","description":"Cardioassist-method of circulatory assist; internal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43232","name":"Esophagoscopy w/us needle bx","description":"Esophagoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90945","name":"Dialysis one evaluation","description":"Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies), with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2803.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","name":"Anes nrv msc upr a&e tndsis","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34806","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91013","name":"Esophgl motil w/stim/perfus","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67835","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin, with free mucous membrane graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35703","name":"Expl n/flwd surg lxtr art","description":"Exploration not followed by surgical repair, artery; lower extremity (eg, common femoral, deep femoral, superficial femoral, popliteal, tibial, peroneal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2534.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76881","name":"Us compl joint r-t w/img","description":"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15135","name":"Drm agrft f/s/n/h/f/g/m 1st","description":"Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67570","name":"Decompress optic nerve","description":"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38208","name":"Thaw preserved stem cells","description":"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing, per donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80439","name":"Trh stimulation panel","description":"Thyrotropin releasing hormone (trh) stimulation panel; 2 hour this panel must include the following: thyroid stimulating hormone (tsh) (84443 x 4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30920","name":"Ligation upper jaw artery","description":"Ligation arteries; internal maxillary artery, transantral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20692","name":"Appl mltpln uni ext fixj sys","description":"Application of a multiplane (pins or wires in more than 1 plane), unilateral, external fixation system (eg, ilizarov, monticelli type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50234","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through same incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27350","name":"Removal of kneecap","description":"Patellectomy or hemipatellectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43204","name":"Esoph scope w/sclerosis inj","description":"Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77422","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4657.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82777","name":"Galectin-3","description":"Galectin-3","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82945","name":"Glucose other fluid","description":"Glucose, body fluid, other than blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25431","name":"Repair nonunion carpal bone","description":"Repair of nonunion of carpal bone (excluding carpal scaphoid (navicular)) (includes obtaining graft and necessary fixation), each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92310","name":"Contact lens fitting ou","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens, both eyes, except for aphakia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1571.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82777","name":"Galectin-3","description":"Galectin-3","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","name":"Anes insj penile prosthesis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33217","name":"Insert 2 electrode pm-defib","description":"Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15757","name":"Free skin flap microvasc","description":"Free skin flap with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1445.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88321","name":"Consltj&reprt sld prep elswr","description":"Consultation and report on referred slides prepared elsewhere","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94645","name":"Cont inhlj tx each addl hour","description":"Continuous inhalation treatment with aerosol medication for acute airway obstruction; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22802","name":"Arthrd pst dfrm 7-12 vrt sgm","description":"Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1837.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41827","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27075","name":"Resect hip tumor","description":"Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis pubis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1778.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64752","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35301","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":996.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62116","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52450","name":"Transurethral inc prostate","description":"Transurethral incision of prostate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80434","name":"Insulin tolerance panel","description":"Insulin tolerance panel; for acth insufficiency this panel must include the following: cortisol (82533 x 5) glucose (82947 x 5)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95904","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","name":"Anes dx/ther nrv blk&inj prn","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28510","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31225","name":"Removal of upper jaw","description":"Maxillectomy; without orbital exenteration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1367.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24149","name":"Radical resection of elbow","description":"Radical resection of capsule, soft tissue, and heterotopic bone, elbow, with contracture release (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0223","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20693","name":"Adjmt/revj ext fixj sys anes","description":"Adjustment or revision of external fixation system requiring anesthesia (eg, new pin[s] or wire[s] and/or new ring[s] or bar[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"Esrd srv 4 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38573","name":"Laps pelvic lymphadec","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46285","name":"Remove anal fist 2 stage","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83866","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7529.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23350","name":"Injection for shoulder x-ray","description":"Injection procedure for shoulder arthrography or enhanced ct/mri shoulder arthrography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90375","name":"Rabies ig im/sc","description":"Rabies immune globulin (rig), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42200","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, soft and/or hard palate only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4335","name":"Incontinence supply","description":"Incontinence supply; miscellaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32310","name":"Removal of chest lining","description":"Pleurectomy, parietal (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62362","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99358","name":"Prolong service w/o contact","description":"Prolonged evaluation and management service before and/or after direct patient care; first hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4099","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44701","name":"Intraop colon lavage add-on","description":"Intraoperative colonic lavage (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11100","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33688","name":"Clsr 1vsd w/wo ptch rmvl bnd","description":"Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33477","name":"Implant tcat pulm vlv perq","description":"Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61567","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2349.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92132","name":"Cptrzd oph dx img ant sgm","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), anterior segment, with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22310","name":"Closed tx vert fx w/o manj","description":"Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4269","name":"Spermicide","description":"Contraceptive supply, spermicide (e.g., foam, gel), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87512","name":"Gardner vag dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72197","name":"Mri pelvis w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43888","name":"Gstr rstcv px opn rmvl&rplc","description":"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20705","name":"Rmvl i-artic rx delivery dev","description":"Removal of drug-delivery device(s), intra-articular (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24066","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5330.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25455","name":"Epiphysl arrst dstl rds&ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius and ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2563.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38500","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50693","name":"Plmt ureteral stent prq","description":"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; pre-existing nephrostomy tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40830","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; 2.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4657.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15331","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83593","name":"Fractionation ketosteroids","description":"Ketosteroids, 17- (17-ks); fractionation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49080","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35372","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; deep (profunda) femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58263","name":"Vag hyst w/t/o & vag repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87471","name":"Bartonella dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); bartonella henselae and bartonella quintana, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58820","name":"Drain ovary abscess open","description":"Drainage of ovarian abscess; vaginal approach, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3909.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6230","name":"Gauze > 48 sq in water/salne","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67800","name":"Remove eyelid lesion","description":"Excision of chalazion; single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28465","name":"Optx tarsal bone fx each","description":"Open treatment of tarsal bone fracture (except talus and calcaneus), includes internal fixation, when performed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77404","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":576.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4841.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86831","name":"Hla class ii phenotype qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); antibody identification by qualitative panel using complete hla phenotypes, hla class ii","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25820","name":"Arthrd wrist lmtd w/o b1 grf","description":"Arthrodesis, wrist; limited, without bone graft (eg, intercarpal or radiocarpal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2793.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33992","name":"Rmvl perq left heart vad","description":"Removal of percutaneous left heart ventricular assist device, arterial or arterial and venous cannula(s), at separate and distinct session from insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27323","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38740","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","name":"Anes thrc spine wo 1lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97545","name":"Work hardening","description":"Work hardening/conditioning; initial 2 hours","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30460","name":"Revision of nose","description":"Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9152","name":"Speech therapy, re-eval","description":"Speech therapy, re-evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35572","name":"Harvest femoropopliteal vein","description":"Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97166","name":"Ot eval mod complex 45 min","description":"Occupational therapy evaluation, moderate complexity, requiring these components: an occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy records and additional review of physical, cognitive, or psychosocial history related to current func","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95800","name":"Slp stdy unattended","description":"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72114","name":"X-ray exam l-s spine bending","description":"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"S3819","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93797","name":"Phys/qhp op car rhab wo ecg","description":"Physician or other qualified health care professional services for outpatient cardiac rehabilitation; without continuous ecg monitoring (per session)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81174","name":"Ar gene known famil variant","description":"Ar (androgen receptor) (eg, spinal and bulbar muscular atrophy, kennedy disease, x chromosome inactivation) gene analysis; known familial variant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33472","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47556","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with dilation of biliary duct stricture(s) with stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36860","name":"External cannula declotting","description":"External cannula declotting (separate procedure); without balloon catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","name":"Anes arthr/ndsc tot wrst rpl","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1496.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42720","name":"I&d absc phrngl ntraorl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26115","name":"Exc hand les sc < 1.5 cm","description":"Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; less than 1.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57112","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1167.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99449","name":"Ntrprof ph1/ntrnet/ehr 31/>","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63283","name":"Bx/exc idrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1736.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82728","name":"Assay of ferritin","description":"Ferritin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54420","name":"Revision of penis","description":"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93270","name":"Remote 30 day ecg rev/report","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; recording (includes connection, recording, and disconnection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22861","name":"Rev rplcm arthrp 1ntrspc crv","description":"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2126.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29040","name":"Appl bdy cst sho to hip head","description":"Application of body cast, shoulder to hips; including head, minerva type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27720","name":"Repair of tibia","description":"Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78459","name":"Myocrd img pet single study","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69720","name":"Release facial nerve","description":"Decompression facial nerve, intratemporal; lateral to geniculate ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1124.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95170","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; whole body extract of biting insect or other arthropod (specify number of doses)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15610","name":"Delay flap arms/legs","description":"Delay of flap or sectioning of flap (division and inset); at scalp, arms, or legs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67440","name":"Explore/drain eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":996.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65273","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1444.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82286","name":"Assay of bradykinin","description":"Bradykinin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44408","name":"Colonoscopy w/decompression","description":"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78585","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28003","name":"Treatment of foot infection","description":"Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94240","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","name":"Anes px hrt w/pump age 1yr+","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30000","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal, internal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32656","name":"Thoracoscopy w/pleurectomy","description":"Thoracoscopy, surgical; with parietal pleurectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33018","name":"Prcrd drg 0-5yr or w/anomly","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; birth through 5 years of age or any age with congenital cardiac anomaly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41110","name":"Excision of tongue lesion","description":"Excision of lesion of tongue without closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90677","name":"Pcv20 vaccine im","description":"Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51703","name":"Insert bladder cath complex","description":"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57461","name":"Conz of cervix w/scope leep","description":"Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22554","name":"Arthrd ant ntrbd min dsc crv","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below c2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21933","name":"Exc back tum deep 5 cm/>","description":"Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1766.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2250","name":"Remot img sub by pt, non e/m","description":"Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or p","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91110","name":"Gi trc img intral esoph-ile","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50394","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26750","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49550","name":"Rpr rem hernia init reduce","description":"Repair initial femoral hernia, any age; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29715","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4160","name":"Ef ped caloric dense>/=0.7kc","description":"Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11421","name":"Exc h-f-nk-sp b9+marg 0.6-1","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95056","name":"Photo tests","description":"Photo tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31510","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, indirect; with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43266","name":"Egd endoscopic stent place","description":"Esophagogastroduodenoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0174T","name":"Cad cxr with interp","description":"Computer-aided detection (cad) (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation and report, with or without digitization of film radiographic images, chest radiograph(s), performed concurrent with primary interpretation (list s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15100","name":"Splt agrft t/a/l 1st 100sqcm","description":"Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33853","name":"Rpr hypopl a-arch w/byp","description":"Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1591.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35141","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, common femoral artery (profunda femoris, superficial femoral)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28302","name":"Incision of ankle bone","description":"Osteotomy; talus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58823","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37605","name":"Ligation int/com carotid art","description":"Ligation; internal or common carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49451","name":"Replace duod/jej tube perc","description":"Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27607","name":"Treat lower leg bone lesion","description":"Incision (eg, osteomyelitis or bone abscess), leg or ankle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27329","name":"Resect thigh/knee tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85732","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); substitution, plasma fractions, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67101","name":"Repair detached retina crtx","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31780","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27170","name":"Repair/graft femur head/neck","description":"Bone graft, femoral head, neck, intertrochanteric or subtrochanteric area (includes obtaining bone graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":996.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96910","name":"Photchmtx tar&uvb/ptrltm&uvb","description":"Photochemotherapy; tar and ultraviolet b (goeckerman treatment) or petrolatum and ultraviolet b","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95803","name":"Actigraphy testing","description":"Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2147.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3652","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"Acoustic immitance testing","description":"Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","name":"Anes ivntl rad artl crtd/c","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5971.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46210","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61610","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2422.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78265","name":"Gstr emptg img sm bwl trnst","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83858","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15574","name":"Pedcle fh/ch/ch/m/n/ax/g/h/f","description":"Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27193","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36625","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); cutdown","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42821","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; age 12 or over","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30560","name":"Lysis intranasal synechia","description":"Lysis intranasal synechia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15240","name":"Fth/gft f/c/c/m/n/ax/g/h/f20","description":"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22103","name":"Remove extra spine segment","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65771","name":"Radial keratotomy","description":"Radial keratotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19307","name":"Mast mod rad","description":"Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77055","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92523","name":"Speech sound lang comprehen","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"Per pm reeval est pat 65+ yr","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 ye","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70554","name":"Fmri brain by tech","description":"Magnetic resonance imaging, brain, functional mri; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90676","name":"Rabies vaccine id","description":"Rabies vaccine, for intradermal use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19272","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93452","name":"Left hrt cath w/ventrclgrphy","description":"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4668.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90821","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70480","name":"Ct orbit/ear/fossa w/o dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49205","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67343","name":"Release eye tissue","description":"Release of extensive scar tissue without detaching extraocular muscle (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5955.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87340","name":"Hepatitis b surface ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31420","name":"Epiglottidectomy","description":"Epiglottidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49652","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52283","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with steroid injection into stricture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99339","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22850","name":"Remove spine fixation device","description":"Removal of posterior nonsegmental instrumentation (eg, harrington rod)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59076","name":"Fetal shunt placement w/us","description":"Fetal shunt placement, including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73722","name":"Mri joint of lwr extr w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27550","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26432","name":"Repair finger tendon","description":"Closed treatment of distal extensor tendon insertion, with or without percutaneous pinning (eg, mallet finger)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41016","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53265","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral caruncle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44207","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1476.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27620","name":"Explore/treat ankle joint","description":"Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72270","name":"Myelogphy 2/> spine regions","description":"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51729","name":"Cystometrogram w/vp&up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61798","name":"Srs cranial lesion complex","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58600","name":"Division of fallopian tube","description":"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44187","name":"Lap ileo/jejuno-stomy","description":"Laparoscopy, surgical; ileostomy or jejunostomy, non-tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97018","name":"Paraffin bath therapy","description":"Application of a modality to 1 or more areas; paraffin bath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43332","name":"Transab esoph hiat hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78710","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85170","name":"Blood clot retraction","description":"Clot retraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75658","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","name":"Anes gastrocnemius recession","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28675","name":"Repair of toe dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32557","name":"Insert cath pleura w/ image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25606","name":"Perq skel fixj dstl rdl fx","description":"Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"Init pm e/m new pat 65+ yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and old","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57010","name":"Colpotomy drg pel abscess","description":"Colpotomy; with drainage of pelvic abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31395","name":"Reconstruct larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; with reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2241.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72084","name":"X-ray exam entire spi 6/> vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":979.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25929","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6079.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49421","name":"Ins tun ip cath for dial opn","description":"Insertion of tunneled intraperitoneal catheter for dialysis, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50384","name":"Remove ureter stent percut","description":"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6455.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82489","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92621","name":"Auditory function + 15 min","description":"Evaluation of central auditory function, with report; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49013","name":"Prpertl pel pack hemrrg trma","description":"Preperitoneal pelvic packing for hemorrhage associated with pelvic trauma, including local exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80168","name":"Assay of ethosuximide","description":"Ethosuximide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","name":"Anes th ivnt rad ntrthrc/jug","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T5001","name":"Position seat spec orth need","description":"Positioning seat for persons with special orthopedic needs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94260","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58615","name":"Occlude fallopian tube(s)","description":"Occlusion of fallopian tube(s) by device (eg, band, clip, falope ring) vaginal or suprapubic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58548","name":"Lap radical hyst","description":"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1194.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"Esrd srv 2-3 vsts p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15574","name":"Pedcle fh/ch/ch/m/n/ax/g/h/f","description":"Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84105","name":"Assay of urine phosphorus","description":"Phosphorus inorganic (phosphate); urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27503","name":"Treatment of thigh fracture","description":"Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, with manipulation, with or without skin or skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20250","name":"Biopsy vrt bdy open thoracic","description":"Biopsy, vertebral body, open; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45342","name":"Sigmoidoscopy w/us guide bx","description":"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2415.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5105.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97750","name":"Physical performance test","description":"Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4879.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44010","name":"Incision of small bowel","description":"Duodenotomy, for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66225","name":"Repair/graft eye lesion","description":"Repair of scleral staphyloma with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59430","name":"Care after delivery","description":"Postpartum care only (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78483","name":"Heart first pass multiple","description":"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93555","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87140","name":"Culture type immunofluoresc","description":"Culture, typing; immunofluorescent method, each antiserum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64415","name":"Njx aa&/strd brch plxs img","description":"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52287","name":"Cystoscopy chemodenervation","description":"Cystourethroscopy, with injection(s) for chemodenervation of the bladder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28635","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47142","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; total right lobectomy (segments v, vi, vii and viii)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3968.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19288","name":"Perq dev breast add mr guide","description":"Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including magnetic resonance guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95984","name":"Alys brn npgt prgrmg addl 15","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0180","name":"Md certification hha patient","description":"Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2472.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26607","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, with manipulation, with external fixation, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3047.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82300","name":"Assay of cadmium","description":"Cadmium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20827","name":"Replantation thumb complete","description":"Replantation, thumb (includes distal tip to mp joint), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92609","name":"Use of speech device service","description":"Therapeutic services for the use of speech-generating device, including programming and modification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":741.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81343","name":"Ppp2r2b gen detc abnor allel","description":"Ppp2r2b (protein phosphatase 2 regulatory subunit bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32220","name":"Release of lung","description":"Decortication, pulmonary (separate procedure); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1267.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44100","name":"Biopsy of bowel","description":"Biopsy of intestine by capsule, tube, peroral (1 or more specimens)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":83.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82615","name":"Test for urine cystines","description":"Cystine and homocystine, urine, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","name":"Anes px vn upr arm&elbw nos","description":"Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95934","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52352","name":"Cystouretero w/stone remove","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7272","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19272","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31627","name":"Navigational bronchoscopy","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation (list separately in addition to code for primary procedure[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88112","name":"Cytopath cell enhance tech","description":"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75630","name":"X-ray aorta leg arteries","description":"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45540","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99355","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38308","name":"Incision of lymph channels","description":"Lymphangiotomy or other operations on lymphatic channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26770","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22903","name":"Exc abd les sc 3 cm/>","description":"Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29740","name":"Wedging of cast","description":"Wedging of cast (except clubfoot casts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20982","name":"Ablate bone tumor(s) perq","description":"Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3102.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33332","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90801","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"Esrd home pt serv p mo 2-11","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57425","name":"Laparoscopy surg colpopexy","description":"Laparoscopy, surgical, colpopexy (suspension of vaginal apex)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6524.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23406","name":"Incise tendon(s) & muscle(s)","description":"Tenotomy, shoulder area; multiple tendons through same incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58565","name":"Hysteroscopy sterilization","description":"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11100","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17266","name":"Dstrj mal les t/a/l >4.0 cm","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50130","name":"Pyelotomy w/removal calculus","description":"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73220","name":"Mri uppr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58670","name":"Laparoscopy tubal cautery","description":"Laparoscopy, surgical; with fulguration of oviducts (with or without transection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64634","name":"Destroy c/th facet jnt addl","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); cervical or thoracic, each additional facet joint (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31085","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99479","name":"Sbsq ic lbw inf 1,500-2,500","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering low birth weight infant (present body weight of 1,500-2,500 grams)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33735","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; closed heart (blalock-hanlon type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37242","name":"Vasc embolize/occlude artery","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, other than hemorrhage or tumor (eg, congenital or acquired arterial malformations, arteriovenous malfo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3798.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65865","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93788","name":"Ambl bp mntr w/sw a/r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; scanning analysis with report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1366.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33750","name":"Shunt subclavian to pulm art","description":"Shunt; subclavian to pulmonary artery (blalock-taussig type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27253","name":"Treat hip dislocation","description":"Open treatment of hip dislocation, traumatic, without internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32608","name":"Thoracoscopy w/bx nodule","description":"Thoracoscopy; with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23450","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; putti-platt procedure or magnuson type operation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61700","name":"Brain aneurysm repr simple","description":"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44402","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6932.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77021","name":"Mri guidance ndl plmt rs&i","description":"Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46505","name":"Chemodenervation anal musc","description":"Chemodenervation of internal anal sphincter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65150","name":"Revise ocular implant","description":"Reinsertion of ocular implant; with or without conjunctival graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11022.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81204","name":"Ar gene charac alleles","description":"Ar (androgen receptor) (eg, spinal and bulbar muscular atrophy, kennedy disease, x chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1627.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40831","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; over 2.5 cm or complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83701","name":"Lipoprotein bld hr fraction","description":"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95962","name":"Electrode stim brain add-on","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70492","name":"Ct sft tsue nck w/o & w/dye","description":"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49570","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11732","name":"Avlsn nail plate simple each","description":"Avulsion of nail plate, partial or complete, simple; each additional nail plate (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1601.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78494","name":"Heart image spect","description":"Cardiac blood pool imaging, gated equilibrium, spect, at rest, wall motion study plus ejection fraction, with or without quantitative processing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11921","name":"Correct skn color 6.1-20.0cm","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.1 to 20.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31590","name":"Reinnervate larynx","description":"Laryngeal reinnervation by neuromuscular pedicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9985","name":"Remote e/m est. pt 25mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a detailed history; a detailed exami","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35571","name":"Art byp pop-tibl-prl-other","description":"Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0238","name":"Oth resp proc, indiv","description":"Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17272","name":"Dstr mal les s/n/h/f/g 1.1-2","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86335","name":"Immunfix e-phorsis/urine/csf","description":"Immunofixation electrophoresis; other fluids with concentration (eg, urine, csf)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35276","name":"Rpr blvs gr ot/t vn ntrth wo","description":"Repair blood vessel with graft other than vein; intrathoracic, without bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25394","name":"Repair carpal bone shorten","description":"Osteoplasty, carpal bone, shortening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31661","name":"Bronch thermoplsty 2/> lobes","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86644","name":"Cmv antibody","description":"Antibody; cytomegalovirus (cmv)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5376.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2634.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48020","name":"Removal of pancreatic stone","description":"Removal of pancreatic calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74330","name":"X-ray bile/panc endoscopy","description":"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93524","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53854","name":"Trurl dstrj prst8 tiss rf wv","description":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82575","name":"Creatinine clearance test","description":"Creatinine; clearance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0325","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0453","name":"Cont intraop neuro monitor","description":"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2426.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22226","name":"Osteot dsc ant 1vrt sgm ea","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"Office o/p new mod 45 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or excee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96913","name":"Photochemotx sev dermatoses","description":"Photochemotherapy (goeckerman and/or puva) for severe photoresponsive dermatoses requiring at least 4-8 hours of care under direct supervision of the physician (includes application of medication and dressings)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20250","name":"Biopsy vrt bdy open thoracic","description":"Biopsy, vertebral body, open; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21627","name":"Sternal debridement","description":"Sternal debridement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32960","name":"Therapeutic pneumothorax","description":"Pneumothorax, therapeutic, intrapleural injection of air","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28280","name":"Fusion of toes","description":"Syndactylization, toes (eg, webbing or kelikian type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65730","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27707","name":"Osteotomy fibula","description":"Osteotomy; fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87073","name":"Culture bacteria anaerobic","description":"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54830","name":"Remove epididymis lesion","description":"Excision of local lesion of epididymis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84437","name":"Assay of neonatal thyroxine","description":"Thyroxine; requiring elution (eg, neonatal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86813","name":"Hla typing a b or c","description":"Hla typing; a, b, or c, multiple antigens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25635","name":"Cltx carpl fx w/mnpj ea b1","description":"Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); with manipulation, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33875","name":"Thoracic aortic graft","description":"Descending thoracic aorta graft, with or without bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2394.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47570","name":"Laparo cholecystoenterostomy","description":"Laparoscopy, surgical; cholecystoenterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66850","name":"Removal of lens material","description":"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4550","name":"Surgical trays","description":"Surgical trays","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70549","name":"Mr angiograph neck w/o&w/dye","description":"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36466","name":"Njx noncmpnd sclrsnt mlt vn","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","name":"Anes px art knee&pop exc&grf","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92371","name":"Rpr&refit spct prsth aphakia","description":"Repair and refitting spectacles; spectacle prosthesis for aphakia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4736.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42410","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1549.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64771","name":"Sever cranial nerve","description":"Transection or avulsion of other cranial nerve, extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97755","name":"Assistive technology assess","description":"Assistive technology assessment (eg, to restore, augment or compensate for existing function, optimize functional tasks and/or maximize environmental accessibility), direct one-on-one contact, with written report, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55180","name":"Revision of scrotum","description":"Scrotoplasty; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67346","name":"Biopsy eye muscle","description":"Biopsy of extraocular muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61860","name":"Implant neuroelectrodes","description":"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36011","name":"Place catheter in vein","description":"Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35112","name":"Repair artery rupture spleen","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, splenic artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93501","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48554","name":"Transpl allograft pancreas","description":"Transplantation of pancreatic allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2120.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76350","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28666","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36593","name":"Declot vascular device","description":"Declotting by thrombolytic agent of implanted vascular access device or catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2623.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21338","name":"Open nasoethmoid fx w/o fixj","description":"Open treatment of nasoethmoid fracture; without external fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85306","name":"Clot inhibit prot s free","description":"Clotting inhibitors or anticoagulants; protein s, free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88385","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"R0075","name":"Transport port x-ray multipl","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2551.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52500","name":"Trurl resection bladder neck","description":"Transurethral resection of bladder neck (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34713","name":"Perq access & clsr fem art","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 french or larger), including ultrasound guidance, when performed, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37230","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5095.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1304.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37226","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64575","name":"Opn impltj nea perph nerve","description":"Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0464","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82610","name":"Cystatin c","description":"Cystatin c","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92618","name":"Ex for nonspeech dev rx add","description":"Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0453","name":"Cont intraop neuro monitor","description":"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43810","name":"Gastroduodenostomy","description":"Gastroduodenostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27647","name":"Resect talus/calcaneus tum","description":"Radical resection of tumor; talus or calcaneus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27345","name":"Removal of knee cyst","description":"Excision of synovial cyst of popliteal space (eg, bakers cyst)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59412","name":"Antepartum manipulation","description":"External cephalic version, with or without tocolysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566T","name":"Autol cell implt adps njx","description":"Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; injection of cellular implant into knee joint including ultrasound guidance, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75901","name":"Remove cva device obstruct","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80157","name":"Assay carbamazepine free","description":"Carbamazepine; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28313","name":"Repair deformity of toe","description":"Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63267","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28490","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97014","name":"Electric stimulation therapy","description":"Application of a modality to 1 or more areas; electrical stimulation (unattended)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82042","name":"Other source albumin quan ea","description":"Albumin; other source, quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60505","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43020","name":"Incision of esophagus","description":"Esophagotomy, cervical approach, with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25240","name":"Partial removal of ulna","description":"Excision distal ulna partial or complete (eg, darrach type or matched resection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51845","name":"Repair bladder neck","description":"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, stamey, raz, modified pereyra)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46947","name":"Hemorrhoidopexy by stapling","description":"Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31781","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervicothoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53025","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45160","name":"Excision of rectal lesion","description":"Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46705","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64898","name":"Nrv grf mltst arm/leg >4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87164","name":"Dark field exam spec collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61480","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46612","name":"Anoscopy remove lesions","description":"Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21179","name":"Rcnstj forehead with grafts","description":"Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1281.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69511","name":"Extensive mastoid surgery","description":"Mastoidectomy; radical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64738","name":"Incision of jaw nerve","description":"Transection or avulsion of; inferior alveolar nerve by osteotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0005","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; group counseling by a clinician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78832","name":"Rp loclzj tum spect w/ct 2","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","name":"Anes thrc spine wo 1lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97542","name":"Wheelchair mngment training","description":"Wheelchair management (eg, assessment, fitting, training), each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95976","name":"Alys smpl cn npgt prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93281","name":"Pm device progr eval multi","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97608","name":"Neg prs wnd ther ndme>50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1566.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93653","name":"Compre ep eval tx svt","description":"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording and catheter ablation of arrhythmogenic focus, including intracardiac electrophysiologic 3-dimensiona","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7168.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27222","name":"Treat hip socket fracture","description":"Closed treatment of acetabulum (hip socket) fracture(s); with manipulation, with or without skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53405","name":"Revise urethra stage 2","description":"Urethroplasty; second stage (formation of urethra), including urinary diversion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87633","name":"Resp virus 12-25 targets","description":"Infectious agent detection by nucleic acid (dna or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31649","name":"Bronchial valve remov addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22852","name":"Remove spine fixation device","description":"Removal of posterior segmental instrumentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84110","name":"Assay of porphobilinogen","description":"Porphobilinogen, urine; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4099","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20934","name":"Intercalary algrft compl","description":"Allograft, includes templating, cutting, placement and internal fixation, when performed; intercalary, complete (ie, cylindrical) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27612","name":"Exploration of ankle joint","description":"Arthrotomy, posterior capsular release, ankle, with or without achilles tendon lengthening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1273.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40805","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43641","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40845","name":"Reconstruction of mouth","description":"Vestibuloplasty; complex (including ridge extension, muscle repositioning)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1140.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6237.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4526.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4471.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15830","name":"Exc excessive skin abdomen","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46500","name":"Injection into hemorrhoid(s)","description":"Injection of sclerosing solution, hemorrhoids","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33320","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70558","name":"Mri brain w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63040","name":"Laminotomy single cervical","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63663","name":"Revise spine eltrd perq aray","description":"Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2595.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86077","name":"Phys blood bank serv xmatch","description":"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27530","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95938","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78800","name":"Rp loclzj tum 1 area 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91105","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11743.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8311.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95873","name":"Guide nerv destr elec stim","description":"Electrical stimulation for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70559","name":"Mri brain w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":184.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29325","name":"Appl hip spica cast1&1/2","description":"Application of hip spica cast; 1 and one-half spica or both legs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3260","name":"Ambulatory surgical boot eac","description":"Surgical boot/shoe, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":149.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3362.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12051","name":"Intmd rpr face/mm 2.5 cm/<","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35152","name":"Repair ruptd popliteal art","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, popliteal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1234.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32488","name":"Completion pneumonectomy","description":"Removal of lung, other than pneumonectomy; with all remaining lung following previous removal of a portion of lung (completion pneumonectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1918.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28304","name":"Incision of midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0190","name":"Mifepristone, oral, 200 mg","description":"Mifepristone, oral, 200 mg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26776","name":"Pin finger dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27630","name":"Removal of tendon lesion","description":"Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86835","name":"Hla class ii semiquant panel","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); semi-quantitative panel (eg, titer), hla class ii","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21032","name":"Remove exostosis maxilla","description":"Excision of maxillary torus palatinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17273","name":"Dstr mal les s/n/h/f/g 2.1-3","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25622","name":"Cltx carpl scphd fx w/o mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43830","name":"Gstrst open wo constj tube","description":"Gastrostomy, open; without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23105","name":"Arthrotomy glenohumeral jt","description":"Arthrotomy; glenohumeral joint, with synovectomy, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28290","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1496.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46040","name":"I&d ischiorct&/perirct absc","description":"Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69805","name":"Explore inner ear","description":"Endolymphatic sac operation; without shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28039","name":"Exc foot/toe tum sc 1.5 cm/>","description":"Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1206","name":"Topical fluoride varnish","description":"Topical fluoride varnish; therapeutic application for moderate to high caries risk patients","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38746","name":"Remove thoracic lymph nodes","description":"Thoracic lymphadenectomy by thoracotomy, mediastinal and regional lymphadenectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26490","name":"Revise thumb tendon","description":"Opponensplasty; superficialis tendon transfer type, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87476","name":"Lyme dis dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia burgdorferi, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19286","name":"Perq dev breast add us imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including ultrasound guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96367","name":"Tx/proph/dg addl seq iv inf","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0101T","name":"Esw muscskel sys nos","description":"Extracorporeal shock wave involving musculoskeletal system, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1945.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85307","name":"Assay activated protein c","description":"Activated protein c (apc) resistance assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44345","name":"Revision of colostomy","description":"Revision of colostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23473","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1370.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92971","name":"Cardioassist external","description":"Cardioassist-method of circulatory assist; external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52007","name":"Cysto urtrl cathj brush bx","description":"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77411","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45541","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); perineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87510","name":"Gardner vag dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80173","name":"Assay of haloperidol","description":"Haloperidol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0408","name":"Inpt/tele follow up 35","description":"Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28225","name":"Release of foot tendon","description":"Tenolysis, extensor, foot; single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64744","name":"Incise nerve back of head","description":"Transection or avulsion of; greater occipital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25085","name":"Incision of wrist capsule","description":"Capsulotomy, wrist (eg, contracture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64446","name":"Njx aa&/strd sc nrv nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93464","name":"Exercise w/hemodynamic meas","description":"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2526.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1610.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93892","name":"Tcd emboli detect w/o inj","description":"Transcranial doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64872","name":"Subsequent repair of nerve","description":"Suture of nerve; requiring secondary or delayed suture (list separately in addition to code for primary neurorrhaphy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50393","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64461","name":"Pvb thoracic single inj site","description":"Paravertebral block (pvb) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31730","name":"Intro windpipe wire/tube","description":"Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90812","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15976.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44391","name":"Colonoscopy for bleeding","description":"Colonoscopy through stoma; with control of bleeding, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78585","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24925","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26545","name":"Reconstruct finger joint","description":"Reconstruction, collateral ligament, interphalangeal joint, single, including graft, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23182","name":"Prtl excision bone scapula","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24655","name":"Cltx rdl head/nck fx w/mnpj","description":"Closed treatment of radial head or neck fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94727","name":"Gas dil/wshot deter lng vol","description":"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4458","name":"Reusable enema bag","description":"Enema bag with tubing, reusable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48511","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21320","name":"Clsd tx nsl fx w/mnpj&stablj","description":"Closed treatment of nasal bone fracture with manipulation; with stabilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","name":"Anes px heart w/o pump oxtj","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52318","name":"Remove bladder stone","description":"Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47135","name":"Transplantation of liver","description":"Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4521.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93318","name":"Echo transesophageal intraop","description":"Echocardiography, transesophageal (tee) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85362","name":"Fibrin degradation products","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); agglutination slide, semiquantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87804","name":"Influenza assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; influenza","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3174.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78710","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65265","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50590","name":"Fragmenting of kidney stone","description":"Lithotripsy, extracorporeal shock wave","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93283","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantab","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27425","name":"Lat retinacular release open","description":"Lateral retinacular release, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61608","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2956.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63075","name":"Neck spine disk surgery","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26356","name":"Repair finger/hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); primary, without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21194","name":"Reconst lwr jaw w/graft","description":"Reconstruction of mandibular rami, horizontal, vertical, c, or l osteotomy; with bone graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1144.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21462","name":"Optx mndblr fx w/ntrdntl","description":"Open treatment of mandibular fracture; with interdental fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27325","name":"Neurectomy hamstring","description":"Neurectomy, hamstring muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28665","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96904","name":"Whole body photography","description":"Whole body integumentary photography, for monitoring of high risk patients with dysplastic nevus syndrome or a history of dysplastic nevi, or patients with a personal or familial history of melanoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4607.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]},{"negotiated_type":"negotiated","negotiated_rate":1867.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33852","name":"Rpr hypopl a-arch wo byp","description":"Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95954","name":"Eeg monitoring/giving drugs","description":"Pharmacological or physical activation requiring physician or other qualified health care professional attendance during eeg recording of activation phase (eg, thiopental activation test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19294","name":"Prepj tum cav iort prtl mast","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82638","name":"Assay of dibucaine number","description":"Dibucaine number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92561","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50728","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","name":"Anes vag px crv cerclage","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78433","name":"Myocrd img pet 2rtracer ct","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99224","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88177","name":"Cytp fna eval ea addl","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93890","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0245","name":"Tub stool or bench","description":"Tub stool or bench","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72292","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98967","name":"Ph1 assmt&mgmt nqhp 11-20","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66174","name":"Trluml dil aq o/f can w/o st","description":"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); without retention of device or stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64859","name":"Nerve surgery","description":"Suture of each additional major peripheral nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33508","name":"Endoscopic vein harvest","description":"Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31610","name":"Tracheostomy fenest skin flp","description":"Tracheostomy, fenestration procedure with skin flaps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71275","name":"Ct angiography chest","description":"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69930","name":"Implant cochlear device","description":"Cochlear device implantation, with or without mastoidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82487","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33257","name":"Ablate atria lmtd add-on","description":"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6309.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2557.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1703.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30310","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; requiring general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68371","name":"Harvest eye tissue alograft","description":"Harvesting conjunctival allograft, living donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47146","name":"Prep donor liver/venous","description":"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56810","name":"Perineoplasty rpr per nonob","description":"Perineoplasty, repair of perineum, nonobstetrical (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59150","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28530","name":"Treat sesamoid bone fracture","description":"Closed treatment of sesamoid fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31646","name":"Brnchsc w/ther aspir sbsq","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22630","name":"Arthrd pst tq 1ntrspc lum","description":"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1412.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20957","name":"Mt bone graft microvasc","description":"Bone graft with microvascular anastomosis; metatarsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2337.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1431.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15756","name":"Free myo/skin flap microvasc","description":"Free muscle or myocutaneous flap with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1458.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30545","name":"Rpr choanal atresia trsnpltn","description":"Repair choanal atresia; transpalatine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25445","name":"Arthrp w/prostc trapezium","description":"Arthroplasty with prosthetic replacement; trapezium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45390","name":"Colonoscopy w/resection","description":"Colonoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68745","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95249","name":"Cont gluc mntr pt prov eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook-up, calibration of monitor, patient training, and printout of recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86359","name":"T cells total count","description":"T cells; total count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","name":"Anes 2&3 burn less 4 % tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; less than 4% total body surface area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27742","name":"Repair of leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula; and distal femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27295","name":"Amputation of leg at hip","description":"Disarticulation of hip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33440","name":"Rplcmt a-valve tlcj autol pv","description":"Replacement, aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved conduit replacement of pulmonary valve (ross-konno procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59866","name":"Abortion (mpr)","description":"Multifetal pregnancy reduction(s) (mpr)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63016","name":"Remove spine lamina >2 thrc","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1367.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","name":"Anes integ sys rcnstv breast","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45520","name":"Treatment of rectal prolapse","description":"Perirectal injection of sclerosing solution for prolapse","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78831","name":"Rp loclzj tum spect 2 areas","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1662.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27217","name":"Treat pelvic ring fracture","description":"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes pubic symphysis and/or ipsilateral superior/inferior rami)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94452","name":"Hast w/i&r phys/qhp","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4232.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85049","name":"Automated platelet count","description":"Blood count; platelet, automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58600","name":"Division of fallopian tube","description":"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36478","name":"Endovenous laser 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39502","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3137.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"Esrd srv 2-3 vsts p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70546","name":"Mr angiograph head w/o&w/dye","description":"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86356","name":"Mononuclear cell antigen","description":"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4162","name":"Ef ped specmetabolic inherit","description":"Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33572","name":"Open coronary endarterectomy","description":"Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or right coronary artery performed in conjunction with coronary artery bypass graft procedure, each vessel (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33289","name":"Tcat impl wrls p-art prs snr","description":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring, including deployment and calibration of the sensor, right heart catheterization, selective pulmonary catheterization, radiological supervision and interpretation, and pulmonary artery angiog","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27828","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of both tibia and fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22812","name":"Arthrd ant dfrm 8+ vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1876.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63057","name":"Decompress spine cord add-on","description":"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15300","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25660","name":"Cltx rdcrpl/ntrcrpl dislc 1+","description":"Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38241","name":"Transplt autol hct/donor","description":"Hematopoietic progenitor cell (hpc); autologous transplantation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","name":"Anes hrna rpr upr abd nos","description":"Anesthesia for hernia repairs in upper abdomen; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","name":"Anes opn upr 2/3 fem rad res","description":"Anesthesia for open procedures involving upper two-thirds of femur; radical resection","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63707","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27676","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; with fibular osteotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":81.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73223","name":"Mri joint upr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33732","name":"Repair heart-vein defect","description":"Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29590","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546T","name":"Rf spectrsc ntraop mrgn asmt","description":"Radiofrequency spectroscopy, real time, intraoperative margin assessment, at the time of partial mastectomy, with report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99177","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with on-site analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96377","name":"Applicaton on-body injector","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69666","name":"Repair middle ear structures","description":"Repair oval window fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84630","name":"Assay of zinc","description":"Zinc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93294","name":"Rem interrog evl pm/ldls pm","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, or leadless pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2023","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91052","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35481","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00860","name":"Anes xtrprtl px lwr abd nos","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33212","name":"Insert pulse gen sngl lead","description":"Insertion of pacemaker pulse generator only; with existing single lead","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72270","name":"Myelogphy 2/> spine regions","description":"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70542","name":"Mri orbit/face/neck w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92083","name":"Extended visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, hump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69511","name":"Extensive mastoid surgery","description":"Mastoidectomy; radical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92512","name":"Nasal function studies","description":"Nasal function studies (eg, rhinomanometry)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9979","name":"Remote e/m new pt 20mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: an expanded problem focused history; an expanded problem focused ex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67345","name":"Destroy nerve of eye muscle","description":"Chemodenervation of extraocular muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43870","name":"Closure gastrostomy surgical","description":"Closure of gastrostomy, surgical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","name":"Tumor immunohistochem/manual","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0110T","name":"Nos quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using other stimuli to assess sensation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50225","name":"Removal kidney open complex","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35905","name":"Excision graft thorax","description":"Excision of infected graft; thorax","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1553.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29838","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, extensive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8914","name":"Mra w/o fol w/cont, lwr ext","description":"Magnetic resonance angiography without contrast followed by with contrast, lower extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5037.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73719","name":"Mri lower extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94619","name":"Exercise tst brncspsm wo ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; without electrocardiographic recording(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85291","name":"Clot factor xiii fibrin scrn","description":"Clotting; factor xiii (fibrin stabilizing), screen solubility","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27786","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64510","name":"N block stellate ganglion","description":"Injection, anesthetic agent; stellate ganglion (cervical sympathetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15822","name":"Blepharoplasty upper eyelid","description":"Blepharoplasty, upper eyelid;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29870","name":"Arthrs knee dx w/wo syn bx","description":"Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92358","name":"Aphakia prosth service temp","description":"Prosthesis service for aphakia, temporary (disposable or loan, including materials)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43825","name":"Gastrojejunostomy w/vagotomy","description":"Gastrojejunostomy; with vagotomy, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27848","name":"Treat ankle dislocation","description":"Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; with repair or internal or external fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20969","name":"Bone/skin graft microvasc","description":"Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2241.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78709","name":"K flow/funct image multiple","description":"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23031","name":"I&d shoulder infected bursa","description":"Incision and drainage, shoulder area; infected bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54055","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93452","name":"Left hrt cath w/ventrclgrphy","description":"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11040","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29866","name":"Autgrft implnt knee w/scope","description":"Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty) (includes harvesting of the autograft[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34848","name":"Visc & infraren abd 4+ prost","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2396.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92507","name":"Tx sp lang voice comm indiv","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50391","name":"Instll rx agnt into rnal tub","description":"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1550.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","KM","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3656.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58540","name":"Revision of uterus","description":"Hysteroplasty, repair of uterine anomaly (strassman type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61537","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2271.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44020","name":"Explore small intestine","description":"Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21630","name":"Radical resection sternum","description":"Radical resection of sternum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62284","name":"Injection for myelogram","description":"Injection procedure for myelography and/or computed tomography, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31643","name":"Diag bronchoscope/catheter","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of catheter(s) for intracavitary radioelement application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35654","name":"Bpg axillary-femoral-femoral","description":"Bypass graft, with other than vein; axillary-femoral-femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1206.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99375","name":"Home health care supervision","description":"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, alzheimers facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6023","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78830","name":"Rp loclzj tum spect w/ct 1","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27006","name":"Tenotomy abductor&/xtnsr hip","description":"Tenotomy, abductors and/or extensor(s) of hip, open (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87350","name":"Hepatitis be ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis be antigen (hbeag)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62294","name":"Injection into spinal artery","description":"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99477","name":"Init day hosp neonate care","description":"Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or younger, who requires intensive observation, frequent interventions, and other intensive care services","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76506","name":"Echo exam of head","description":"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74174","name":"Cta abd&plvs w/contrast","description":"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45395","name":"Lap removal of rectum","description":"Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1572.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43228","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33871","name":"Transvrs a-arch grf hypthrm","description":"Transverse aortic arch graft, with cardiopulmonary bypass, with profound hypothermia, total circulatory arrest and isolated cerebral perfusion with reimplantation of arch vessel(s) (eg, island pedicle or individual arch vessel reimplantation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2854.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29902","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced ulnar collateral ligament (eg, stener lesion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15171","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78430","name":"Myocrd img pet rst/strs w/ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88112","name":"Cytopath cell enhance tech","description":"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46753","name":"Reconstruction of anus","description":"Graft (thiersch operation) for rectal incontinence and/or prolapse","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20696","name":"App mltpln uni xtrnl fix 1st","description":"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; initial and subsequent alignment(s), assessment(s), and computation(s) of adjustment schedule(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83068","name":"Hemoglobin unstable screen","description":"Hemoglobin; unstable, screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86638","name":"Q fever antibody","description":"Antibody; coxiella burnetii (q fever)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":380.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50600","name":"Exploration of ureter","description":"Ureterotomy with exploration or drainage (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88318","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4565.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64405","name":"Njx aa&/strd gr ocpl nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87327","name":"Cryptococcus neoform ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cryptococcus neoformans","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61596","name":"Transcochlear approach/skull","description":"Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1991.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20604","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70549","name":"Mr angiograph neck w/o&w/dye","description":"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11106","name":"Incal bx skn single les","description":"Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41140","name":"Removal of tongue","description":"Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1691.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52630","name":"Remove prostate regrowth","description":"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37235","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59515","name":"Cesarean delivery","description":"Cesarean delivery only; including postpartum care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1130.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","name":"Anes arthr/ndsc tot wrst rpl","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36469","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26236","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93308","name":"Tte f-up or lmtd","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1125.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32095","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8685","name":"Implt nrostm pls gen sng rec","description":"Implantable neurostimulator pulse generator, single array, rechargeable, includes extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6369.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58552","name":"Laparo-vag hyst incl t/o","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62318","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"Prev visit new age 18-39","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31623","name":"Dx bronchoscope/brush","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78223","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82533","name":"Total cortisol","description":"Cortisol; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0106T","name":"Touch quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using touch pressure stimuli to assess large diameter sensation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43251","name":"Egd remove lesion snare","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82542","name":"Col chromotography qual/quan","description":"Column chromatography, includes mass spectrometry, if performed (eg, hplc, lc, lc/ms, lc/ms-ms, gc, gc/ms-ms, gc/ms, hplc/ms), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78459","name":"Myocrd img pet single study","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00528","name":"Anes clsd ch mediast&thrc wo","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4542","name":"Small disposable underpad","description":"Incontinence product, disposable underpad, small size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85348","name":"Coagulation time otr method","description":"Coagulation time; other methods","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","name":"Anes xtrprt lwr abd prst8ect","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"Office o/p est low 20 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or e","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97542","name":"Wheelchair mngment training","description":"Wheelchair management (eg, assessment, fitting, training), each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27455","name":"Realignment of knee","description":"Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); before epiphyseal closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4108.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67902","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37615","name":"Ligation major artery neck","description":"Ligation, major artery (eg, post-traumatic, rupture); neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44130","name":"Bowel to bowel fusion","description":"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35494","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84150","name":"Assay of prostaglandin","description":"Prostaglandin, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63103","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic or lumbar, each additional segment (list separately in addition to code for primary proc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5167.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76513","name":"Oph us dx ant sgm us uni/bi","description":"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) b-scan or high resolution biomicroscopy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99451","name":"Ntrprof ph1/ntrnet/ehr 5/>","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a written report to the patients treating/requesting physician or other qualified health care professional, 5 mi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44146","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92609","name":"Use of speech device service","description":"Therapeutic services for the use of speech-generating device, including programming and modification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46262","name":"Remove in/ex hem grps w/fist","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97028","name":"Ultraviolet therapy","description":"Application of a modality to 1 or more areas; ultraviolet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12208.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62115","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1527.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33736","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; open heart with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68100","name":"Biopsy conjunctiva","description":"Biopsy of conjunctiva","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67915","name":"Repair eyelid defect","description":"Repair of ectropion; thermocauterization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83992","name":"Assay for phencyclidine","description":"Phencyclidine (pcp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43633","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with roux-en-y reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00452","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42825","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; younger than age 12","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70481","name":"Ct orbit/ear/fossa w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44100","name":"Biopsy of bowel","description":"Biopsy of intestine by capsule, tube, peroral (1 or more specimens)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74249","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72270","name":"Myelogphy 2/> spine regions","description":"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32035","name":"Thoracostomy w/rib resection","description":"Thoracostomy; with rib resection for empyema","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35494","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95923","name":"Autonomic nrv syst funj test","description":"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56442","name":"Hymenotomy","description":"Hymenotomy, simple incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11720","name":"Debride nail 1-5","description":"Debridement of nail(s) by any method(s); 1 to 5","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0463","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37735","name":"Lig&div&compl strpg saph vn","description":"Ligation and division and complete stripping of long or short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of deep fascia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38240","name":"Transplt allo hct/donor","description":"Hematopoietic progenitor cell (hpc); allogeneic transplantation per donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62325","name":"Njx interlaminar crv/thrc","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thorac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19364","name":"Brst rcnstj free flap","description":"Breast reconstruction; with free flap (eg, ftram, diep, siea, gap flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1780.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92610","name":"Evaluate swallowing function","description":"Evaluation of oral and pharyngeal swallowing function","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43300","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61524","name":"Removal of brain lesion","description":"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76942","name":"Echo guide for biopsy","description":"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50955","name":"Ureter endoscopy & biopsy","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42235","name":"Repair palate","description":"Repair of anterior palate, including vomer flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6023","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":109.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93242","name":"Ext ecg>48hr<7d recording","description":"External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; recording (includes connection and initial recording)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87497","name":"Cytomeg dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35201","name":"Repair blood vessel dir neck","description":"Repair blood vessel, direct; neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":820.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43754","name":"Dx gastr intub w/asp spec","description":"Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24071","name":"Exc arm/elbow les sc 3 cm/>","description":"Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81312","name":"Pabpn1 gene detc abnor allel","description":"Pabpn1 (poly[a] binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11305","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1913.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP08","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57280","name":"Suspension of vagina","description":"Colpopexy, abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43212","name":"Esophagoscop stent placement","description":"Esophagoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57550","name":"Removal of residual cervix","description":"Excision of cervical stump, vaginal approach;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26261","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5048.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90809","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44157","name":"Colectomy w/ileoanal anast","description":"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, includes loop ileostomy, and rectal mucosectomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75665","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72157","name":"Mri chest spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33681","name":"Closure 1 vsd w/wo patch","description":"Closure of single ventricular septal defect, with or without patch;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1597.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73503","name":"X-ray exam hip uni 4/> views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20985","name":"Cptr-asst dir ms px","description":"Computer-assisted surgical navigational procedure for musculoskeletal procedures, image-less (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84583","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; semiquantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84432","name":"Assay of thyroglobulin","description":"Thyroglobulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25392","name":"Shorten radius & ulna","description":"Osteoplasty, radius and ulna; shortening (excluding 64876)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":859.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27818","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99475","name":"Ped crit care age 2-5 init","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42815","name":"Excision of neck cyst","description":"Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45100","name":"Biopsy of rectum","description":"Biopsy of anorectal wall, anal approach (eg, congenital megacolon)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61700","name":"Brain aneurysm repr simple","description":"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1668.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L0210","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42900","name":"Repair throat wound","description":"Suture pharynx for wound or injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75563","name":"Card mri w/stress img & dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61600","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1801.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78430","name":"Myocrd img pet rst/strs w/ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21181","name":"Rcnst cntrg b9 tum crnl xtrc","description":"Reconstruction by contouring of benign tumor of cranial bones (eg, fibrous dysplasia), extracranial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93453","name":"R&l hrt cath w/ventriclgrphy","description":"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62292","name":"Njx chemonucleolysis lmbr","description":"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43832","name":"Gstrst open w/constj tube","description":"Gastrostomy, open; with construction of gastric tube (eg, janeway procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82690","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C1879","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92990","name":"Revision of pulmonary valve","description":"Percutaneous balloon valvuloplasty; pulmonary valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28222","name":"Release of foot tendons","description":"Tenolysis, flexor, foot; multiple tendons","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54164","name":"Frenulotomy of penis","description":"Frenulotomy of penis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83008","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0148","name":"Scr c/v cyto, autosys, rescr","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2062.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49446","name":"Change g-tube to g-j perc","description":"Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50327","name":"Prep renal graft/venous","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2028.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88248","name":"Chromosome analysis 50-100","description":"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, fanconi anemia, fragile x)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77031","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52285","name":"Cystoscopy and treatment","description":"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and fulguration of polyp(s) of urethra, bladder neck, and/or ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57022","name":"I&d vaginal hematoma ob/pp","description":"Incision and drainage of vaginal hematoma; obstetrical/postpartum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93235","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64412","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68505","name":"Partial removal tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92618","name":"Ex for nonspeech dev rx add","description":"Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86756","name":"Respiratory virus antibody","description":"Antibody; respiratory syncytial virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78472","name":"Gated heart planar single","description":"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69643","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61781","name":"Scan proc cranial intra","description":"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28193","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29867","name":"Allgrft implnt knee w/scope","description":"Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35142","name":"Repair artery rupture thigh","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, common femoral artery (profunda femoris, superficial femoral)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9486","name":"Remote e/m est. pt 10mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward med","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33681","name":"Closure 1 vsd w/wo patch","description":"Closure of single ventricular septal defect, with or without patch;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1597.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35606","name":"Bpg carotid-subclavian","description":"Bypass graft, with other than vein; carotid-subclavian","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2109.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42890","name":"Limited pharyngectomy","description":"Limited pharyngectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38242","name":"Transplt allo lymphocytes","description":"Allogeneic lymphocyte infusions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27871","name":"Fusion of tibiofibular joint","description":"Arthrodesis, tibiofibular joint, proximal or distal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35606","name":"Bpg carotid-subclavian","description":"Bypass graft, with other than vein; carotid-subclavian","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34101","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; axillary, brachial, innominate, subclavian artery, by arm incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80408","name":"Aldosterone suppression eval","description":"Aldosterone suppression evaluation panel (eg, saline infusion) this panel must include the following: aldosterone (82088 x 2) renin (84244 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26160","name":"Remove tendon sheath lesion","description":"Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76102","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41530","name":"Tongue base vol reduction","description":"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15570","name":"Skin pedicle flap trunk","description":"Formation of direct or tubed pedicle, with or without transfer; trunk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19370","name":"Revj peri-implt capsule brst","description":"Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17314","name":"Mohs addl stage t/a/l","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41153","name":"Tongue mouth neck surgery","description":"Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0143","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5233.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4879.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37619","name":"Ligation of inf vena cava","description":"Ligation of inferior vena cava","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1522.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4189.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21395","name":"Opn tx orbit periorbt w/grft","description":"Open treatment of orbital floor blowout fracture; periorbital approach with bone graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95961","name":"Electrode stimulation brain","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","name":"Anes open px lower l/a/f nos","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22116","name":"Remove extra spine segment","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","name":"Anes ther ivntl rad artl nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44403","name":"Colonoscopy w/resection","description":"Colonoscopy through stoma; with endoscopic mucosal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00792","name":"Anes iper upr abd prtl hptc","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; partial hepatectomy or management of liver hemorrhage (excluding liver biopsy)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34712","name":"Tcat dlvr enhncd fixj dev","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99184","name":"Hypothermia ill neonate","description":"Initiation of selective head or total body hypothermia in the critically ill neonate, includes appropriate patient selection by review of clinical, imaging and laboratory data, confirmation of esophageal temperature probe location, evaluation of amplitude eeg, supervision of controlled hypothermia, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53442","name":"Remove/revise male sling","description":"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99485","name":"Suprv interfacilty transport","description":"Supervision by a control physician of interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with transport team before transport, at the referring facility and during the transport, including data inter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97763","name":"Orthc/prostc mgmt sbsq enc","description":"Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47563","name":"Laparo cholecystectomy/graph","description":"Laparoscopy, surgical; cholecystectomy with cholangiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99145","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48400","name":"Injection intraop add-on","description":"Injection procedure for intraoperative pancreatography (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61541","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for transection of corpus callosum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1970.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49250","name":"Excision of umbilicus","description":"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93462","name":"L hrt cath trnsptl puncture","description":"Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84591","name":"Assay of nos vitamin","description":"Vitamin, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72127","name":"Ct neck spine w/o & w/dye","description":"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28264","name":"Release of midfoot joint","description":"Capsulotomy, midtarsal (eg, heyman type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0248T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86821","name":"Lymphocyte culture mixed","description":"Hla typing; lymphocyte culture, mixed (mlc)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89060","name":"Exam synovial fluid crystals","description":"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95920","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","name":"Anes arthr/ndsc wrst/hnd nos","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68320","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with conjunctival graft or extensive rearrangement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93571","name":"Iv dop vel&/press c flo 1st","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; initial vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49326","name":"Lap w/omentopexy add-on","description":"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33254","name":"Ablate atria lmtd","description":"Operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92286","name":"Ant sgm img i&r speclr mic","description":"Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73718","name":"Mri lower extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","name":"Anes px vn upr arm&elbw nos","description":"Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54001","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","name":"Anes ther ivntl rad ven nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47570","name":"Laparo cholecystoenterostomy","description":"Laparoscopy, surgical; cholecystoenterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57210","name":"Repair vagina/perineum","description":"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92608","name":"Ex for speech device rx addl","description":"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"Per pm reeval est pat 65+ yr","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 ye","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15241","name":"Fth/gft f/c/c/m/n/a/g/h/f ea","description":"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29845","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22633","name":"Arthrd cmbn 1ntrspc lumbar","description":"Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1642.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4530","name":"Ped size brief/diaper lg","description":"Pediatric sized disposable incontinence product, brief/diaper, large size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483T","name":"Tmvi percutaneous approach","description":"Transcatheter mitral valve implantation/replacement (tmvi) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44406","name":"Colonoscopy w/ultrasound","description":"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94453","name":"Hast w/suppl oxygen titrj","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57510","name":"Cauterization of cervix","description":"Cautery of cervix; electro or thermal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49424","name":"Assess cyst contrast inject","description":"Contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34831","name":"Open aortoiliac prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bi-iliac prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1702.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11601","name":"Exc tr-ext mal+marg 0.6-1 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99452","name":"Ntrprof ph1/ntrnet/ehr rfrl","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1898.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31240","name":"Nsl/sns ndsc cnch bull rescj","description":"Nasal/sinus endoscopy, surgical; with concha bullosa resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25565","name":"Cltx rdl&uln shft fx w/mnpj","description":"Closed treatment of radial and ulnar shaft fractures; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28116","name":"Revision of foot","description":"Ostectomy, excision of tarsal coalition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4183.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21160","name":"Rcnst mdfc lfrtiii advm w/i","description":"Reconstruction midface, lefort iii (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); with lefort i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29889","name":"Arthrs aid pcl rpr/agmntj","description":"Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85557","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; incubated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88738","name":"Hgb quant transcutaneous","description":"Hemoglobin (hgb), quantitative, transcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45910","name":"Dilation of rectal narrowing","description":"Dilation of rectal stricture (separate procedure) under anesthesia other than local","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61585","name":"Orbitocranial approach/skull","description":"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2962.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10061","name":"I&d abscess comp/multiple","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42808","name":"Excise pharynx lesion","description":"Excision or destruction of lesion of pharynx, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0400","name":"Home sleep test/type 4 porta","description":"Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A7043","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75561","name":"Cardiac mri for morph w/dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0603","name":"Electric breast pump","description":"Breast pump, electric (ac and/or dc), any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75630","name":"X-ray aorta leg arteries","description":"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87380","name":"Hepatitis delta agent ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis, delta agent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22532","name":"Arthrd lat xtrcvtry tq thrc","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1603.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93533","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32501","name":"Repair bronchus add-on","description":"Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27175","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by traction, without reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77402","name":"Radiation tx delivery lvl 1","description":"Radiation treatment delivery; level 1 (eg, single-electron field, multiple-electron fields, or 2d photons), including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27310","name":"Exploration of knee joint","description":"Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80176","name":"Assay of lidocaine","description":"Lidocaine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27884","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; secondary closure or scar revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4083","name":"Enteral stomach tube levine","description":"Stomach tube - levine type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0447","name":"Behavior counsel obesity 15m","description":"Face-to-face behavioral counseling for obesity, 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49553","name":"Rpr fem hernia init blocked","description":"Repair initial femoral hernia, any age; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2609","name":"Custom fabricate w/c cushion","description":"Custom fabricated wheelchair seat cushion, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28299","name":"Cor hlx vlgs double osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88304","name":"Tissue exam by pathologist","description":"Level iii - surgical pathology, gross and microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque bartholins gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel t","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3005.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20662","name":"Application halo pelvic","description":"Application of halo, including removal; pelvic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88142","name":"Cytopath c/v thin layer","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50760","name":"Ureteroureterostomy","description":"Ureteroureterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87320","name":"Chlmyd trach ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; chlamydia trachomatis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33933","name":"Prepare donor heart/lung","description":"Backbench standard preparation of cadaver donor heart/lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, and trachea for implantation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45110","name":"Removal of rectum","description":"Proctectomy; complete, combined abdominoperineal, with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1477.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99458","name":"Rpm tx mgmt ea addl 20 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9604","name":"One-way allow prorated trip","description":"Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67311","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 horizontal muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71275","name":"Ct angiography chest","description":"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64610","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","name":"Anes thrcm px pulm rescj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46700","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; adult","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58346","name":"Insert heyman uteri capsule","description":"Insertion of heyman capsules for clinical brachytherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26460","name":"Incise hand/finger tendon","description":"Tenotomy, extensor, hand or finger, open, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23195","name":"Resection humeral head","description":"Resection, humeral head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15922","name":"Exc coccygl pr ulc flap clsr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with flap closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15824","name":"Rhytidectomy forehead","description":"Rhytidectomy; forehead","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0148T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61870","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54450","name":"Preputial stretching","description":"Foreskin manipulation including lysis of preputial adhesions and stretching","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29358","name":"Appl long leg cast brace","description":"Application of long leg cast brace","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27418","name":"Repair degenerated kneecap","description":"Anterior tibial tubercleplasty (eg, maquet type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57410","name":"Pelvic examination","description":"Pelvic examination under anesthesia (other than local)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95027","name":"Iq tsts seql&incrl airborne","description":"Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67225","name":"Eye photodynamic ther add-on","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (list separately in addition to code for primary eye treatment)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57061","name":"Destruction vag lesions smpl","description":"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43880","name":"Closure gastrocolic fistula","description":"Closure of gastrocolic fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1326.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45190","name":"Destruction rectal tumor","description":"Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33391","name":"Valvuloplasty aortic valve","description":"Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or annuloplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1995.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23600","name":"Cltx prox humrl fx w/o mnpj","description":"Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26863","name":"Fuse/graft added joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft), each additional joint (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61800","name":"Apply srs headframe add-on","description":"Application of stereotactic headframe for stereotactic radiosurgery (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48001","name":"Placement of drain pancreas","description":"Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1941.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14001","name":"Tis trnfr trunk 10.1-30sqcm","description":"Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0344","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93631","name":"Ntraop epicar&endcar pac&map","description":"Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27886","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; re-amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1487.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63082","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4300","name":"Cath impl vasc access portal","description":"Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37243","name":"Vasc embolize/occlude organ","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4783.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97032","name":"Appl modality 1+estim ea 15","description":"Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1572.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"S3819","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"Esrd srv 2-3 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per m","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25274","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38381","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; thoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3890","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33803","name":"Div aberrant vsl w/reanast","description":"Division of aberrant vessel (vascular ring); with reanastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58976","name":"Transfer of embryo","description":"Gamete, zygote, or embryo intrafallopian transfer, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80200","name":"Assay of tobramycin","description":"Tobramycin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0001","name":"2019-ncov diagnostic p","description":"Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59121","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20700","name":"Mnl prep&insj dp rx dlvr dev","description":"Manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27455","name":"Realignment of knee","description":"Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); before epiphyseal closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"Review patient spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; review and interpretation only by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33783","name":"Nikaidoh proc w/ostia implt","description":"Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, nikaidoh procedure); with reimplantation of 1 or both coronary ostia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3051.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21120","name":"Genioplasty augmentation","description":"Genioplasty; augmentation (autograft, allograft, prosthetic material)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86280","name":"Hemagglutination inhibition","description":"Hemagglutination inhibition test (hai)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25652","name":"Optx ulnar styloid fracture","description":"Open treatment of ulnar styloid fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KL","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86153","name":"Cell enumeration phys interp","description":"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); physician interpretation and report, when required","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64508","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91306","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92273","name":"Full field erg w/i&r","description":"Electroretinography (erg), with interpretation and report; full field (ie, fferg, flash erg, ganzfeld erg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69660","name":"Revise middle ear bone","description":"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36200","name":"Place catheter in aorta","description":"Introduction of catheter, aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43220","name":"Esophagoscopy balloon <30mm","description":"Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33964","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition central cannula(e) by sternotomy or thoracotomy, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78830","name":"Rp loclzj tum spect w/ct 1","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67938","name":"Remove eyelid foreign body","description":"Removal of embedded foreign body, eyelid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62318","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49525","name":"Repair ing hernia sliding","description":"Repair inguinal hernia, sliding, any age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62291","name":"Njx px discography crv/thrc","description":"Injection procedure for discography, each level; cervical or thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21180","name":"Rcnstj forehead w/autograft","description":"Reconstruction, entire or majority of forehead and/or supraorbital rims; with autograft (includes obtaining grafts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1314.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95950","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47510","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26070","name":"Explore/treat hand joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11954","name":"Subq njx fil matrl>10.0 cc","description":"Subcutaneous injection of filling material (eg, collagen); over 10.0 cc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21247","name":"Reconstruct lower jaw bone","description":"Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"R0070","name":"Transport portable x-ray","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63081","name":"Remove vert body dcmprn crvl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1568.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49084","name":"Peritoneal lavage","description":"Peritoneal lavage, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3727.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47362","name":"Repair liver wound","description":"Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1215.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95146","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 2 single stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2324.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45126","name":"Pelvic exenteration","description":"Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy, or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), or any combination thereof","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2204.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21155","name":"Rcnstj mdfc lefort iii w/i","description":"Reconstruction midface, lefort iii (extracranial), any type, requiring bone grafts (includes obtaining autografts); with lefort i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87500","name":"Vanomycin dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); vancomycin resistance (eg, enterococcus species van a, van b), amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78451","name":"Ht muscle image spect sing","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"Pure tone hearing test air","description":"Screening test, pure tone, air only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4193","name":"Parenteral sol 52-73 gm prot","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86829","name":"Hla class i/ii antibody qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to hla class i or class ii hla antigens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0321","name":"Audio-only hhs","description":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31755","name":"Trachplsty trchphryngl fstlj","description":"Tracheoplasty; tracheopharyngeal fistulization, each stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84163","name":"Pappa serum","description":"Pregnancy-associated plasma protein-a (papp-a)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46740","name":"Construction of absent anus","description":"Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25035","name":"Inc dp bone crtx f/arm&/wrst","description":"Incision, deep, bone cortex, forearm and/or wrist (eg, osteomyelitis or bone abscess)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0423","name":"Intens cardiac rehab no exer","description":"Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55815","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15787","name":"Abrasion lesions add-on","description":"Abrasion; each additional 4 lesions or less (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88368","name":"Insitu hybridization manual","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":538.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78265","name":"Gstr emptg img sm bwl trnst","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75984","name":"Xray control catheter change","description":"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21930","name":"Exc back les sc < 3 cm","description":"Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2910.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58262","name":"Vag hyst including t/o","description":"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93050","name":"Art pressure waveform analys","description":"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity art","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21147","name":"Rcnstj mdfc lefort i 3/>grf","description":"Reconstruction midface, lefort i; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted bilateral alveolar cleft or multiple osteotomies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21261","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2059.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63085","name":"Remove vert body dcmprn thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1709.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35840","name":"Explore abdominal vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1044.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96151","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0454","name":"Md document visit by npp","description":"Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92060","name":"Sensorimotor examination","description":"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50540","name":"Revision of horseshoe kidney","description":"Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96138","name":"Psycl/nrpsyc tech 1st","description":"Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43500","name":"Surgical opening of stomach","description":"Gastrotomy; with exploration or foreign body removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15005","name":"Wnd prep f/n/hf/g addl cm","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; each additional 100 sq cm, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44970","name":"Laparoscopy appendectomy","description":"Laparoscopy, surgical, appendectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2396.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4534","name":"Youth size pull-on","description":"Youth sized disposable incontinence product, protective underwear/pull-on, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95975","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87496","name":"Cytomeg dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61575","name":"Skull base/brainstem surgery","description":"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2303.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01820","name":"Anes clsd px rds u/w/h bones","description":"Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42420","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":923.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82017","name":"Acylcarnitines quant","description":"Acylcarnitines; quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9538","name":"Tc99m pyrophosphate","description":"Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36578","name":"Replace tunneled cv cath","description":"Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46220","name":"Excise anal ext tag/papilla","description":"Excision of single external papilla or tag, anus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26250","name":"Extensive hand surgery","description":"Radical resection of tumor, metacarpal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43213","name":"Esophagoscopy retro balloon","description":"Esophagoscopy, flexible, transoral; with dilation of esophagus, by balloon or dilator, retrograde (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87205","name":"Smear gram stain","description":"Smear, primary source with interpretation; gram or giemsa stain for bacteria, fungi, or cell types","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33430","name":"Replacement of mitral valve","description":"Replacement, mitral valve, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61790","name":"Treat trigeminal nerve","description":"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26550","name":"Pollicization digit","description":"Pollicization of a digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15771.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1905.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5797.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23485","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation; with bone graft for nonunion or malunion (includes obtaining graft and/or necessary fixation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3989.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2307.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59325","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; abdominal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47785","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of intrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2726.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68340","name":"Separate eyelid adhesions","description":"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33710","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass; with repair of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1340.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88367","name":"Insitu hybridization auto","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19342","name":"Insj/rplcmt brst implt sep d","description":"Insertion or replacement of breast implant on separate day from mastectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0221T","name":"Plmt post facet implt lumb","description":"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92227","name":"Img rta detcj/mntr ds staff","description":"Imaging of retina for detection or monitoring of disease; with remote clinical staff review and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73202","name":"Ct uppr extremity w/o&w/dye","description":"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26020","name":"Drain hand tendon sheath","description":"Drainage of tendon sheath, digit and/or palm, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21407","name":"Opn tx orbit fx w/implant","description":"Open treatment of fracture of orbit, except blowout; with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5100.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31253","name":"Nsl/sins ndsc total","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95706","name":"Eeg wo vid 2-12hr intmt mntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, 2-12 hours; with intermittent monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87470","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78453","name":"Ht muscle image planar sing","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1848.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50040","name":"Nfros nfrot w/drg","description":"Nephrostomy, nephrotomy with drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83516","name":"Immunoassay nonantibody","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63270","name":"Excise intrspinl lesion crvl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68540","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; frontal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99404","name":"Prev med cnsl indiv apprx 60","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53600","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26040","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30410","name":"Reconstruction of nose","description":"Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28555","name":"Repair foot dislocation","description":"Open treatment of tarsal bone dislocation, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36013","name":"Place catheter in artery","description":"Introduction of catheter, right heart or main pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64610","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21740","name":"Reconstruction of sternum","description":"Reconstructive repair of pectus excavatum or carinatum; open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":891.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0240","name":"Bath/shower chair","description":"Bath/shower chair, with or without wheels, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82415","name":"Assay of chloramphenicol","description":"Chloramphenicol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97533","name":"Sensory integration","description":"Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87336","name":"Entamoeb hist dispr ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; entamoeba histolytica dispar group","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":783.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92537","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26862","name":"Fusion/graft of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28045","name":"Exc foot/toe tum deep <1.5cm","description":"Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); less than 1.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34490","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73723","name":"Mri joint lwr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76536","name":"Us exam of head and neck","description":"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85307","name":"Assay activated protein c","description":"Activated protein c (apc) resistance assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28153","name":"Partial removal of toe","description":"Resection, condyle(s), distal end of phalanx, each toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75992","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57268","name":"Repair of bowel bulge","description":"Repair of enterocele, vaginal approach (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84166","name":"Protein e-phoresis/urine/csf","description":"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, csf)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61612","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1216.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"Esrd srv 2-3 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per mo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13120","name":"Cmplx rpr s/a/l 1.1-2.5 cm","description":"Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36834","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46761","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (park posterior anal repair)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97813","name":"Acup 1/> w/estim 1st 15 min","description":"Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65779","name":"Cover eye w/membrane suture","description":"Placement of amniotic membrane on the ocular surface; single layer, sutured","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4158","name":"Ef ped complete intact nut","description":"Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0415","name":"Open tx post pelvic fxcture","description":"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27335","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior and posterior including popliteal area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87230","name":"Toxin/antitoxin asy tiss cul","description":"Toxin or antitoxin assay, tissue culture (eg, clostridium difficile toxin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33207","name":"Insert heart pm ventricular","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4489.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78596","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99334","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63273","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1706.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57465","name":"Cam cervix uteri drg colp","description":"Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63087","name":"Remov vertbr dcmprn thrclmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2143.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50690","name":"Injection for ureter x-ray","description":"Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21433","name":"Optx cranfcl sep comp mlt","description":"Open treatment of craniofacial separation (lefort iii type); complicated (eg, comminuted or involving cranial nerve foramina), multiple surgical approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6260","name":"Wound cleanser any type/size","description":"Wound cleansers, any type, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24330","name":"Flexor-plasty elbow","description":"Flexor-plasty, elbow (eg, steindler type advancement);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29820","name":"Sho arthrs srg prtl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90867","name":"Tcranial magn stim tx plan","description":"Therapeutic repetitive transcranial magnetic stimulation (tms) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21025","name":"Excision of bone lower jaw","description":"Excision of bone (eg, for osteomyelitis or bone abscess); mandible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92537","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23800","name":"Arthrodesis glenohumeral jt","description":"Arthrodesis, glenohumeral joint;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27054","name":"Removal of hip joint lining","description":"Arthrotomy with synovectomy, hip joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29871","name":"Arthrs knee surg for infctj","description":"Arthroscopy, knee, surgical; for infection, lavage and drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3202","name":"Oxford w/ supinat/pronator c","description":"Orthopedic shoe, oxford with supinator or pronator, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63056","name":"Decompress spinal cord lmbr","description":"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal approach) (eg, far lateral herniated intervertebral disc)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1324.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82491","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43241","name":"Egd tube/cath insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35634","name":"Bpg iliorenal","description":"Bypass graft, with other than vein; iliorenal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1564.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21343","name":"Open tx dprsd front sinus fx","description":"Open treatment of depressed frontal sinus fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61705","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2395.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90913","name":"Bfb training ea addl 15 min","description":"Biofeedback training, perineal muscles, anorectal or urethral sphincter, including emg and/or manometry, when performed; each additional 15 minutes of one-on-one physician or other qualified health care professional contact with the patient (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15576","name":"Pedicle e/n/e/l/ntroral","description":"Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, lips, or intraoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6250","name":"Skin seal protect moisturizr","description":"Skin sealants, protectants, moisturizers, ointments, any type, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32602","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":509.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73722","name":"Mri joint of lwr extr w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46261","name":"Remove in/ex hem grps & fiss","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65900","name":"Remove eye lesion","description":"Removal of epithelial downgrowth, anterior chamber of eye","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99359","name":"Prolong serv w/o contact add","description":"Prolonged evaluation and management service before and/or after direct patient care; each additional 30 minutes (list separately in addition to code for prolonged service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","name":"Scr mammo bi incl cad","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59850","name":"Induced abortion 1+ njx","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24358","name":"Repair elbow w/deb open","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); debridement, soft tissue and/or bone, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28660","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","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, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2092.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32480","name":"Partial removal of lung","description":"Removal of lung, other than pneumonectomy; single lobe (lobectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1182.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0877","name":"Pwc gp4 std sing pow opt s/b","description":"Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85230","name":"Clot factor vii proconvertin","description":"Clotting; factor vii (proconvertin, stable factor)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25441","name":"Arthrp w/prostc dstl rds","description":"Arthroplasty with prosthetic replacement; distal radius","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93922","name":"Upr/l xtremity art 2 levels","description":"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waveform recording and analysis at 1-2 levels, or ankle/brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30435","name":"Revision of nose","description":"Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53265","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral caruncle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88312","name":"Special stains group 1","description":"Special stain including interpretation and report; group i for microorganisms (eg, acid fast, methenamine silver)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99156","name":"Mod sed oth phys/qhp 5/>yrs","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient age 5 year","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61708","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2341.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20973","name":"Bone/skin graft great toe","description":"Free osteocutaneous flap with microvascular anastomosis; great toe with web space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2557.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83625","name":"Assay of ldh enzymes","description":"Lactate dehydrogenase (ld), (ldh); isoenzymes, separation and quantitation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96160","name":"Pt-focused hlth risk assmt","description":"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19287","name":"Perq dev breast 1st mr guide","description":"Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including magnetic resonance guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0431","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62319","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20937","name":"Sp bone agrft morsel add-on","description":"Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48554","name":"Transpl allograft pancreas","description":"Transplantation of pancreatic allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2120.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93455","name":"Coronary art/grft angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1762.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17311","name":"Mohs 1 stage h/n/hf/g","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), h","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81172","name":"Aff2 gen alys charac alleles","description":"Aff2 (alf transcription elongation factor 2 [fmr2]) (eg, fragile x intellectual disability 2 [fraxe]) gene analysis; characterization of alleles (eg, expanded size and methylation status)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88174","name":"Cytopath c/v auto in fluid","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25924","name":"Amputation follow-up surgery","description":"Disarticulation through wrist; re-amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20822","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes distal tip to sublimis tendon insertion), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1503.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34804","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77414","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55870","name":"Electroejaculation","description":"Electroejaculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00326","name":"Anes all px larynx&trach<1yr","description":"Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95052","name":"Photo patch tests","description":"Photo patch test(s) (specify number of tests)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36500","name":"Insertion of catheter vein","description":"Venous catheterization for selective organ blood sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81271","name":"Htt gene detc abnor alleles","description":"Htt (huntingtin) (eg, huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66170","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36260","name":"Insertion of infusion pump","description":"Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67700","name":"Blepharotomy drg absc eyelid","description":"Blepharotomy, drainage of abscess, eyelid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31626","name":"Bronchoscopy w/markers","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of fiducial markers, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83664","name":"Lamellar bdy fetal lung","description":"Fetal lung maturity assessment; lamellar body density","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7234.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78267","name":"Urea breath tst c-14 acquisj","description":"Urea breath test, c-14 (isotopic); acquisition for analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90291","name":"Cmv ig iv","description":"Cytomegalovirus immune globulin (cmv-igiv), human, for intravenous use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2062.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34845","name":"Visc & infraren abd 1 prosth","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1683.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33020","name":"Incision of heart sac","description":"Pericardiotomy for removal of clot or foreign body (primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4541","name":"Large disposable underpad","description":"Incontinence product, disposable underpad, large, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93533","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2112.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72081","name":"X-ray exam entire spi 1 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68550","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; involving osteotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43217","name":"Esophagoscopy snare les remv","description":"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","name":"Anes integ sys conv arrhyt","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42960","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95873","name":"Guide nerv destr elec stim","description":"Electrical stimulation for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82085","name":"Assay of aldolase","description":"Aldolase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00756","name":"Anes hrna rpr diphrg hrna","description":"Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87385","name":"Histoplasma capsul ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; histoplasma capsulatum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38792","name":"Ra tracer id of sentinl node","description":"Injection procedure; radioactive tracer for identification of sentinel node","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4035","name":"Enteral feed supp pump per d","description":"Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75791","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52647","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54438","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1082.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61570","name":"Remove foreign body brain","description":"Craniectomy or craniotomy; with excision of foreign body from brain","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1709.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49495","name":"Rpr ing hernia baby reduc","description":"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; reducible","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78815","name":"Pet image w/ct skull-thigh","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; skull base to mid-thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27391","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, 1 leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64449","name":"Njx aa&/strd lmbr plex nfs","description":"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9490","name":"Cmmi mod home visit","description":"Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/man","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"R0070","name":"Transport portable x-ray","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11044","name":"Dbrdmt bone 1st 20 sq cm/<","description":"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33786","name":"Repair arterial trunk","description":"Total repair, truncus arteriosus (rastelli type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1984.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81163","name":"Brca1&2 gene full seq alys","description":"Brca1 (brca1, dna repair associated), brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75571","name":"Ct hrt w/o dye w/ca test","description":"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4932","name":"Reusable rectal thermometer","description":"Rectal thermometer, reusable, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53060","name":"Drainage of urethra abscess","description":"Drainage of skenes gland abscess or cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50200","name":"Renal biopsy perq","description":"Renal biopsy; percutaneous, by trocar or needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84445","name":"Assay of tsi globulin","description":"Thyroid stimulating immune globulins (tsi)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35508","name":"Art byp grft carotid-vertbrl","description":"Bypass graft, with vein; carotid-vertebral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3729.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43450","name":"Dilate esophagus 1/mult pass","description":"Dilation of esophagus, by unguided sound or bougie, single or multiple passes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50020","name":"Drg perirnl/renal absc open","description":"Drainage of perirenal or renal abscess, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94453","name":"Hast w/suppl oxygen titrj","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"Per pm reeval est pat infant","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83055","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27326","name":"Neurectomy popliteal","description":"Neurectomy, popliteal (gastrocnemius)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95857","name":"Cholinesterase challenge","description":"Cholinesterase inhibitor challenge test for myasthenia gravis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93745","name":"Set-up cardiovert-defibrill","description":"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ecg, transmission of data to data repository, patient instruction in wearing system and patient re","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37180","name":"Revision of circulation","description":"Venous anastomosis, open; splenorenal, proximal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1872.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0509","name":"Crit care telehea consult 50","description":"Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36598","name":"Inj w/fluor eval cv device","description":"Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32854","name":"Lung transplant with bypass","description":"Lung transplant, double (bilateral sequential or en bloc); with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3934.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4755","name":"Comb art/venous blood tubing","description":"Blood tubing, arterial and venous combined, for hemodialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21390","name":"Opn tx orbit periorbtl implt","description":"Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75901","name":"Remove cva device obstruct","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87081","name":"Culture screen only","description":"Culture, presumptive, pathogenic organisms, screening only;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58974","name":"Embryo transfer intrauterine","description":"Embryo transfer, intrauterine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26260","name":"Resect prox finger tumor","description":"Radical resection of tumor, proximal or middle phalanx of finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","name":"Anes integ sys conv arrhyt","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4523","name":"Adult size brief/diaper lg","description":"Adult sized disposable incontinence product, brief/diaper, large, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97129","name":"Ther ivntj 1st 15 min","description":"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29850","name":"Knee arthroscopy/surgery","description":"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","name":"Anes rad amp pns ingun&ilac","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63266","name":"Excise intrspinl lesion thrc","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1558.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5510","name":"Compression form shoe insert","description":"For diabetics only, direct formed, compression molded to patients foot without external heat source, multiple-density insert(s) prefabricated, per shoe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4542","name":"Small disposable underpad","description":"Incontinence product, disposable underpad, small size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86788","name":"West nile virus ab igm","description":"Antibody; west nile virus, igm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","KL","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22847","name":"Insert spine fixation device","description":"Anterior instrumentation; 8 or more vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6004","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38531","name":"Open bx/exc inguinofem nodes","description":"Biopsy or excision of lymph node(s); open, inguinofemoral node(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57000","name":"Colpotomy w/exploration","description":"Colpotomy; with exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","name":"Anes arthr/ndsc wrst/hnd nos","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40843","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97116","name":"Gait training therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35907","name":"Excision graft abdomen","description":"Excision of infected graft; abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1681.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2026.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0112","name":"Potassium hydroxide preps","description":"All potassium hydroxide (koh) preparations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61770","name":"Incise skull for treatment","description":"Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1484.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87799","name":"Detect agent nos dna quant","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; quantification, each organism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84255","name":"Assay of selenium","description":"Selenium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93590","name":"Perq transcath cls mitral","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2088","name":"Off base opioid tx, add30","description":"Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; each additional 30 minutes beyond the first 120 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308T","name":"Insj ocular telescope prosth","description":"Insertion of ocular telescope prosthesis including removal of crystalline lens or intraocular lens prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45119","name":"Remove rectum w/reservoir","description":"Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, j-pouch), with diverting enterostomy when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1532.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36515","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99252","name":"Ip/obs consltj new/est sf 35","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":541.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96159","name":"Hlth bhv ivntj indiv ea addl","description":"Health behavior intervention, individual, face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77338","name":"Design mlc device for imrt","description":"Multi-leaf collimator (mlc) device(s) for intensity modulated radiation therapy (imrt), design and construction per imrt plan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86631","name":"Chlamydia antibody","description":"Antibody; chlamydia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0432","name":"Eia hiv-1/hiv-2 screen","description":"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44212","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1628.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25315","name":"Revise palsy hand tendon(s)","description":"Flexor origin slide (eg, for cerebral palsy, volkmann contracture), forearm and/or wrist;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93624","name":"Ep f-up study pacg&rec","description":"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0091","name":"Obtaining screen pap smear","description":"Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92284","name":"Dx dark adaptation exam i&r","description":"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43180","name":"Esophagoscopy rigid trnso","description":"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, zenkers diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope and repair, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29819","name":"Sho arthrs srg rmvl loose/fb","description":"Arthroscopy, shoulder, surgical; with removal of loose body or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82776","name":"Galactose transferase test","description":"Galactose-1-phosphate uridyl transferase; screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69714","name":"Impl oi implt skull perq esp","description":"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00810","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2443.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25560","name":"Cltx rdl&uln shft fx wo mnpj","description":"Closed treatment of radial and ulnar shaft fractures; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49427","name":"Injection abdominal shunt","description":"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35251","name":"Rpr blvsl vn grf intra-abdl","description":"Repair blood vessel with vein graft; intra-abdominal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1526.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27040","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01820","name":"Anes clsd px rds u/w/h bones","description":"Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32552","name":"Remove lung catheter","description":"Removal of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87449","name":"Nos each organism ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; not otherwise specified, each organism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65875","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44401","name":"Colonoscopy with ablation","description":"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97012","name":"Mechanical traction therapy","description":"Application of a modality to 1 or more areas; traction, mechanical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54110","name":"Treatment of penis lesion","description":"Excision of penile plaque (peyronie disease);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36415","name":"Coll venous bld venipuncture","description":"Collection of venous blood by venipuncture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","name":"Anes px heart w/o pump oxtj","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15135","name":"Drm agrft f/s/n/h/f/g/m 1st","description":"Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48145","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3493.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","name":"Anes c hyst flwg neuraxial","description":"Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63194","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4341.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92586","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99363","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26135","name":"Revise finger joint each","description":"Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood reconstruction, each digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44365","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57556","name":"Remove cervix repair bowel","description":"Excision of cervical stump, vaginal approach; with repair of enterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72127","name":"Ct neck spine w/o & w/dye","description":"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78814","name":"Pet image w/ct lmtd","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93564","name":"Njx cgen car cath slctv opac","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aortocoronary saphenous vein, free radial artery, or free mammary artery graft) to one or more coronary a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64430","name":"Njx aa&/strd pudendal nerve","description":"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2530.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1026.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1638.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70558","name":"Mri brain w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61334","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0312","name":"Immunize couns < 21yr 5-15 m","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29904","name":"Subtalar arthro w/fb rmvl","description":"Arthroscopy, subtalar joint, surgical; with removal of loose body or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35566","name":"Art byp fem-ant-post tib/prl","description":"Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1474.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5060.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1509.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52402","name":"Cysto trurl rescj ejacul dux","description":"Cystourethroscopy with transurethral resection or incision of ejaculatory ducts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78588","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28360","name":"Reconstruct cleft foot","description":"Reconstruction, cleft foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69670","name":"Remove mastoid air cells","description":"Mastoid obliteration (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98970","name":"Nqhp ol dig assmt&mgmt 5-10","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15937","name":"Exc sac pr ulc prep mus ostc","description":"Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42500","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; primary or simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87562","name":"M.avium-intra dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0610","name":"Annual gynecological examina","description":"Annual gynecological examination, new patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87389","name":"Hiv-1 ag w/hiv-1&-2 ab ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-1 antigen(s), with hiv-1 and hiv-2 antibodies, single resu","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51800","name":"Revision of bladder/urethra","description":"Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22862","name":"Rev rplcm rthrp 1ntrspc lmbr","description":"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2116.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27033","name":"Arthrt hip expl/rmv loose/fb","description":"Arthrotomy, hip, including exploration or removal of loose or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2416.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31370","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); horizontal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15736","name":"Muscle-skin graft arm","description":"Muscle, myocutaneous, or fasciocutaneous flap; upper extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":790.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35471","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41828","name":"Excision of gum lesion","description":"Excision of hyperplastic alveolar mucosa, each quadrant (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64776","name":"Remove digit nerve lesion","description":"Excision of neuroma; digital nerve, 1 or both, same digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1801.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82375","name":"Assay carboxyhb quant","description":"Carboxyhemoglobin; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38240","name":"Transplt allo hct/donor","description":"Hematopoietic progenitor cell (hpc); allogeneic transplantation per donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88387","name":"Macroscopic xm dsj&prep tiss","description":"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12014","name":"Rpr f/e/e/n/l/m 5.1-7.5 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99467","name":"Ped crit care transport addl","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36578","name":"Replace tunneled cv cath","description":"Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52601","name":"Prostatectomy (turp)","description":"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26450","name":"Incision of palm tendon","description":"Tenotomy, flexor, palm, open, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30468","name":"Rpr nsl vlv collapse w/implt","description":"Repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2149.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25263","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50065","name":"Nl sec surg operj calculus","description":"Nephrolithotomy; secondary surgical operation for calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":196.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71090","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2335.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60502","name":"Re-explore parathyroids","description":"Parathyroidectomy or exploration of parathyroid(s); re-exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"Vnpnxr<3yrs phy/qhp scalp vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; scalp vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7260","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":976.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24560","name":"Cltx hum epcndylr fx wo mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35551","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2248.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75946","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49553","name":"Rpr fem hernia init blocked","description":"Repair initial femoral hernia, any age; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87651","name":"Strep a dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65110","name":"Removal of eye","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92606","name":"Non-speech device service","description":"Therapeutic service(s) for the use of non-speech-generating device, including programming and modification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29358","name":"Appl long leg cast brace","description":"Application of long leg cast brace","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20661","name":"Application halo cranial","description":"Application of halo, including removal; cranial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1514.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","name":"Anes thrc spine w/1 lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64623","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54336","name":"Revise penis/urethra","description":"1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57287","name":"Revise/remove sling repair","description":"Removal or revision of sling for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00634","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24546","name":"Optx hum fx w/ntrcndylr xtn","description":"Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; with intercondylar extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43277","name":"Ercp ea duct/ampulla dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with trans-endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla (sphincteroplasty), including sphincterotomy, when performed, each duct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22905","name":"Rad resect abd tumor 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37225","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1703.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99464","name":"Attendance at delivery","description":"Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9512","name":"Tc99m pertechnetate","description":"Technetium tc-99m pertechnetate, diagnostic, per millicurie","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33822","name":"Repair pda div<18 years","description":"Repair of patent ductus arteriosus; by division, younger than 18 years","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0421","name":"Ed svc ckd grp per session","description":"Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4732.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31651","name":"Bronchial valve addl insert","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77386","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51040","name":"Incise & drain bladder","description":"Cystostomy, cystotomy with drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75995","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43231","name":"Esophagoscop ultrasound exam","description":"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54865","name":"Explore epididymis","description":"Exploration of epididymis, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36565","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; without subcutaneous port or pump (eg, tesio type catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64866","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-spinal accessory","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64784","name":"Remove nerve lesion","description":"Excision of neuroma; major peripheral nerve, except sciatic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A4365","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0123","name":"Screen cerv/vag thin layer","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51920","name":"Close bladder-uterus fistula","description":"Closure of vesicouterine fistula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["GT","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42426","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98972","name":"Nqhp ol dig assmt&mgmt 21+","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27497","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor); with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94453","name":"Hast w/suppl oxygen titrj","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26123","name":"Release palm contracture","description":"Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86901","name":"Blood typing serologic rh(d)","description":"Blood typing, serologic; rh (d)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26113","name":"Exc hand tum deep 1.5 cm/>","description":"Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); 1.5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54111","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft to 5 cm in length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60210","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80051","name":"Electrolyte panel","description":"Electrolyte panel this panel must include the following: carbon dioxide (bicarbonate) (82374) chloride (82435) potassium (84132) sodium (84295)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23470","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; hemiarthroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0241","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61538","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2457.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","name":"Anes px vn lwr leg ven thrmb","description":"Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22554","name":"Arthrd ant ntrbd min dsc crv","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below c2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23000","name":"Rmvl sbdltd clcreous dep opn","description":"Removal of subdeltoid calcareous deposits, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54600","name":"Reduce testis torsion","description":"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4875.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22100","name":"Remove part of neck vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92564","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":830.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0144A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1412.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27181","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; osteotomy and internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":948.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85597","name":"Phospholipid pltlt neutraliz","description":"Phospholipid neutralization; platelet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74183","name":"Mri abd w/o cntr flwd cntr","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64718","name":"Revise ulnar nerve at elbow","description":"Neuroplasty and/or transposition; ulnar nerve at elbow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54150","name":"Circumcision w/regionl block","description":"Circumcision, using clamp or other device with regional dorsal penile or ring block","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88239","name":"Tissue culture tumor","description":"Tissue culture for neoplastic disorders; solid tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21360","name":"Opn tx dprsd malar fracture","description":"Open treatment of depressed malar fracture, including zygomatic arch and malar tripod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63003","name":"Remove spine lamina 1/2 thrc","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93642","name":"Ep evl 1/2chmb trnsvns cvdfb","description":"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parame","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85302","name":"Clot inhibit prot c antigen","description":"Clotting inhibitors or anticoagulants; protein c, antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88332","name":"Path consltj surg ea add blk","description":"Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49561","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87274","name":"Herpes simplex 1 ag if","description":"Infectious agent antigen detection by immunofluorescent technique; herpes simplex virus type 1","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6240.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22867","name":"Insj stablj dev w/dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP10","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64823","name":"Sympathectomy supfc palmar","description":"Sympathectomy; superficial palmar arch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74175","name":"Cta abdomen w/contrast","description":"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26605","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; with manipulation, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15276","name":"Skin sub graft f/n/hf/g addl","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3254","name":"Orth foot non-stndard size/w","description":"Non-standard size or width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58661","name":"Laparoscopy remove adnexa","description":"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90586","name":"Bcg vaccine intravesical","description":"Bacillus calmette-guerin vaccine (bcg) for bladder cancer, live, for intravesical use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50727","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32504","name":"Resect apical lung tum/chest","description":"Resection of apical lung tumor (eg, pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; with chest wall reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1639.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77372","name":"Srs linear based","description":"Radiation treatment delivery, stereotactic radiosurgery (srs), complete course of treatment of cranial lesion(s) consisting of 1 session; linear accelerator based","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64613","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58140","name":"Myomectomy abdom method","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2064","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31805","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; intrathoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75946","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78801","name":"Rp loclzj tum 2+area 1+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or m","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3671.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96105","name":"Assessment of aphasia","description":"Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by boston diagnostic aphasia examination) with interpretation and report, per hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","name":"Anes upr gi ndsc px ercp","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ercp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51841","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); complicated (eg, secondary repair)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21421","name":"Cltx palatal/max fx wire fix","description":"Closed treatment of palatal or maxillary fracture (lefort i type), with interdental wire fixation or fixation of denture or splint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21255","name":"Reconstruct lower jaw bone","description":"Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0403","name":"Ekg for initial prevent exam","description":"Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52345","name":"Cysto/uretero w/up stricture","description":"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82945","name":"Glucose other fluid","description":"Glucose, body fluid, other than blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97014","name":"Electric stimulation therapy","description":"Application of a modality to 1 or more areas; electrical stimulation (unattended)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76536","name":"Us exam of head and neck","description":"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67882","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1680.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4723","name":"Dialys sol fld vol > 2999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36575","name":"Repair tunneled cv cath","description":"Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95711","name":"Veeg 2-12 hr unmonitored","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, 2-12 hours; unmonitored","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24153","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42809","name":"Remove pharynx foreign body","description":"Removal of foreign body from pharynx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27043","name":"Exc hip pelvis les sc 3 cm/>","description":"Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80428","name":"Growth hormone panel","description":"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) this panel must include the following: human growth hormone (hgh) (83003 x 4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61343","name":"Crnec sopl crv lam dcmprn","description":"Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, arnold-chiari malformation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2008.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86510","name":"Histoplasmosis skin test","description":"Skin test; histoplasmosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17260","name":"Dstrj mal les t/a/l 0.5 cm/<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28305","name":"Incise/graft midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus; with autograft (includes obtaining graft) (eg, fowler type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25076","name":"Exc forearm tum deep < 3 cm","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34970.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2012","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19120","name":"Removal of breast lesion","description":"Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99316","name":"Nf dschrg mgmt 30 min+","description":"Nursing facility discharge management; more than 30 minutes total time on the date of the encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11600","name":"Exc tr-ext mal+marg 0.5 cm/<","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80416","name":"Renin stimulation panel","description":"Renal vein renin stimulation panel (eg, captopril) this panel must include the following: renin (84244 x 6)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27658","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11301","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3043.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86812","name":"Hla typing a b or c","description":"Hla typing; a, b, or c (eg, a10, b7, b27), single antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50125","name":"Pyelotomy w/drg pyelostomy","description":"Pyelotomy; with drainage, pyelostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23462","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with coracoid process transfer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2109.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82784","name":"Assay iga/igd/igg/igm each","description":"Gammaglobulin (immunoglobulin); iga, igd, igg, igm, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4159","name":"Ef ped complete soy based","description":"Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51102","name":"Drain bl w/cath insertion","description":"Aspiration of bladder; with insertion of suprapubic catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36593","name":"Declot vascular device","description":"Declotting by thrombolytic agent of implanted vascular access device or catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15420","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55725","name":"Drainage of prostate abscess","description":"Prostatotomy, external drainage of prostatic abscess, any approach; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87389","name":"Hiv-1 ag w/hiv-1&-2 ab ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-1 antigen(s), with hiv-1 and hiv-2 antibodies, single resu","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85652","name":"Rbc sed rate automated","description":"Sedimentation rate, erythrocyte; automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27625","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44213","name":"Lap mobil splenic fl add-on","description":"Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21600","name":"Partial removal of rib","description":"Excision of rib, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83901","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4216","name":"Parenteral nutrition additiv","description":"Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27071","name":"Part removal hip bone deep","description":"Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53420","name":"Reconstruct urethra stage 1","description":"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0289","name":"Arthro, loose body + chondro","description":"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26480","name":"Transplant hand tendon","description":"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53510","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; perineal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75902","name":"Remove cva lumen obstruct","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93293","name":"Pm phone r-strip device eval","description":"Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9981","name":"Remote e/m new pt 45mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90911","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69641","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43245","name":"Egd dilate stricture","description":"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46945","name":"Int hrhc lig 1 hroid w/o img","description":"Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72292","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1992.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69990","name":"Microsurgery add-on","description":"Microsurgical techniques, requiring use of operating microscope (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29590","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31645","name":"Brnchsc w/ther aspir 1st","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7900","name":"Male vacuum erection system","description":"Male vacuum erection system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41007","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87491","name":"Chlmyd trach dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52290","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","name":"Anes integumentary sys nos","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86336","name":"Inhibin a","description":"Inhibin a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65880","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95071","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6079.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25100","name":"Biopsy of wrist joint","description":"Arthrotomy, wrist joint; with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25447","name":"Arthrp ntrcrp/crp/mtcr ntrps","description":"Arthroplasty, intercarpal or carpometacarpal joints; interposition (eg, tendon)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38724","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (modified radical neck dissection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62010","name":"Treatment of head injury","description":"Elevation of depressed skull fracture; with repair of dura and/or debridement of brain","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57061","name":"Destruction vag lesions smpl","description":"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66982","name":"Xcapsl ctrc rmvl cplx wo ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72197","name":"Mri pelvis w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95991","name":"Spin/brain pump refil & main","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requiring skill of a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76979","name":"Us trgt dyn mbubb ea addl","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33780","name":"Rpr tga rcnstj clsr vsd","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with closure of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2064.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35022","name":"Repair artery rupture chest","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, innominate, subclavian artery, by thoracic incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1248.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95954","name":"Eeg monitoring/giving drugs","description":"Pharmacological or physical activation requiring physician or other qualified health care professional attendance during eeg recording of activation phase (eg, thiopental activation test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42725","name":"I&d absc phrngl xtrnl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97129","name":"Ther ivntj 1st 15 min","description":"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36470","name":"Njx sclrsnt 1 incmptnt vein","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15952","name":"Exc trchntr pr ulc flp clsr","description":"Excision, trochanteric pressure ulcer, with skin flap closure;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27675","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; without fibular osteotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67027","name":"Implant eye drug system","description":"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44202","name":"Lap enterectomy","description":"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27125","name":"Partial hip replacement","description":"Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16036","name":"Escharotomy ea addl incision","description":"Escharotomy; each additional incision (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27025","name":"Fasciotomy hip/thigh any typ","description":"Fasciotomy, hip or thigh, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58280","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88312","name":"Special stains group 1","description":"Special stain including interpretation and report; group i for microorganisms (eg, acid fast, methenamine silver)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26742","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46937","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5394.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50395","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65280","name":"Repair of eye wound","description":"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0219T","name":"Plmt post facet implt cerv","description":"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24666","name":"Optx radial head/nck fx rplc","description":"Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed; with radial head prosthetic replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93622","name":"Comp ep eval l ventr pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1987.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11604","name":"Exc tr-ext mal+marg 3.1-4 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25076","name":"Exc forearm tum deep < 3 cm","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","name":"Anes rad amp pns ingun&ilac","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32225","name":"Partial release of lung","description":"Decortication, pulmonary (separate procedure); partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11620","name":"Exc h-f-nk-sp mal+marg 0.5/<","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95885","name":"Musc tst done w/nerv tst lim","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","name":"Anes iper upr abd gstr px mo","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20604","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58674","name":"Laps abltj uterine fibroids","description":"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92653","name":"Aep neurodiagnostic i&r","description":"Auditory evoked potentials; neurodiagnostic, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4930","name":"Sterile, gloves per pair","description":"Gloves, sterile, per pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35321","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; axillary-brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96367","name":"Tx/proph/dg addl seq iv inf","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80048","name":"Basic metabolic pnl total ca","description":"Basic metabolic panel (calcium, total) this panel must include the following: calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64755","name":"Incision of stomach nerves","description":"Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47143","name":"Prep donor liver whole","description":"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; without triseg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65400","name":"Removal of eye lesion","description":"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57109","name":"Vagnc bi total pel lymphadec","description":"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33265","name":"Ablate atria lmtd endo","description":"Endoscopy, surgical; operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure), without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73702","name":"Ct lwr extremity w/o&w/dye","description":"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9485","name":"Remote e/m new pt 60mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15832","name":"Exc excessive skin thigh","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54620","name":"Suspension of testis","description":"Fixation of contralateral testis (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4034","name":"Enter feed supkit syr by day","description":"Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92286","name":"Ant sgm img i&r speclr mic","description":"Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57170","name":"Fitting of diaphragm/cap","description":"Diaphragm or cervical cap fitting with instructions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74246","name":"X-ray xm upr gi trc 2cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42405","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; incisional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"Im admin 1st/only component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6473.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45384","name":"Colonoscopy w/lesion removal","description":"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77032","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86593","name":"Syphilis test non-trep quant","description":"Syphilis test, non-treponemal antibody; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20615","name":"Treatment of bone cyst","description":"Aspiration and injection for treatment of bone cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44150","name":"Removal of colon","description":"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1532.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33210","name":"Insert electrd/pm cath sngl","description":"Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45825","name":"Repair fistula w/colostomy","description":"Closure of rectourethral fistula; with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":20.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78122","name":"Whl bld volume determination","description":"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28008","name":"Incision of foot fascia","description":"Fasciotomy, foot and/or toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36416","name":"Collj capillary blood spec","description":"Collection of capillary blood specimen (eg, finger, heel, ear stick)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63706","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; larger than 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71551","name":"Mri chest w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27370","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36410","name":"Vnpnxr 3yr/> phy/qhp dx/ther","description":"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38700","name":"Removal of lymph nodes neck","description":"Suprahyoid lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80412","name":"Crh stimulation panel","description":"Corticotropic releasing hormone (crh) stimulation panel this panel must include the following: cortisol (82533 x 6) adrenocorticotropic hormone (acth) (82024 x 6)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4634.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33978","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61590","name":"Infratemporal approach/skull","description":"Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parotidectomy, craniotomy, decompression and/or mobilization of the facial nerve and/or petrous carotid a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2557.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92342","name":"Fit spectacles multifocal","description":"Fitting of spectacles, except for aphakia; multifocal, other than bifocal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27540","name":"Treat knee fracture","description":"Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54700","name":"I&d epdidyms tstis&/scrot sp","description":"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44126","name":"Enterectomy w/o taper cong","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; without tapering","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3479.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87265","name":"Pertussis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; bordetella pertussis/parapertussis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43760","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54411","name":"Remov/replc penis pros comp","description":"Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19102","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93510","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99487","name":"Cplx chrnc care 1st 60 min","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33969","name":"Ecmo/ecls rmvl perph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40530","name":"Partial removal of lip","description":"Resection of lip, more than one-fourth, without reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15740","name":"Island pedicle flap graft","description":"Flap; island pedicle requiring identification and dissection of an anatomically named axial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80157","name":"Assay carbamazepine free","description":"Carbamazepine; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93624","name":"Ep f-up study pacg&rec","description":"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"Esrd svc pr day pt <2","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4343.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":8244.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29856","name":"Tibial arthroscopy/surgery","description":"Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65771","name":"Radial keratotomy","description":"Radial keratotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21740","name":"Reconstruction of sternum","description":"Reconstructive repair of pectus excavatum or carinatum; open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":891.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1998.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82710","name":"Fats/lipids feces quant","description":"Fat or lipids, feces; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31552","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, age 12 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42310","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary or sublingual, intraoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11771","name":"Exc pilonidal cyst xtnsv","description":"Excision of pilonidal cyst or sinus; extensive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"Immunotherapy injections","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65756","name":"Corneal trnspl endothelial","description":"Keratoplasty (corneal transplant); endothelial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22533.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"Home/res vst new high mdm 75","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26418","name":"Repair finger tendon","description":"Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57210","name":"Repair vagina/perineum","description":"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1918.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54344","name":"Rrp hypspad comp moblj&urtp","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87807","name":"Rsv assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67916","name":"Repair eyelid defect","description":"Repair of ectropion; excision tarsal wedge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1435.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1062.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77002","name":"Needle localization by xray","description":"Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15101","name":"Splt agrft t/a/l ea addl 100","description":"Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15819","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90474","name":"Immune admin oral/nasal addl","description":"Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66600","name":"Remove iris and lesion","description":"Iridectomy, with corneoscleral or corneal section; for removal of lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3060.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78451","name":"Ht muscle image spect sing","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01130","name":"Anes body cast appl/revj","description":"Anesthesia for body cast application or revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50572","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88386","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25805","name":"Arthrd wrist w/sliding graft","description":"Arthrodesis, wrist; with sliding graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93041","name":"Rhythm ecg tracing","description":"Rhythm ecg, 1-3 leads; tracing only without interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13122","name":"Cmplx rpr s/a/l addl 5 cm/>","description":"Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0504","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70559","name":"Mri brain w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83785","name":"Assay of manganese","description":"Manganese","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55000","name":"Drainage of hydrocele","description":"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75660","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80426","name":"Gonadotropin hormone panel","description":"Gonadotropin releasing hormone stimulation panel this panel must include the following: follicle stimulating hormone (fsh) (83001 x 4) luteinizing hormone (lh) (83002 x 4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44960","name":"Appendectomy","description":"Appendectomy; for ruptured appendix with abscess or generalized peritonitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33883","name":"Delayed plmt prox xtn prosth","description":"Delayed placement of proximal extension prosthesis(es) not involving coverage of the left subclavian artery origin, after endovascular repair of the thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and inter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38571","name":"Laparoscopy lymphadenectomy","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62141","name":"Crnop skull defect>5 cm diam","description":"Cranioplasty for skull defect; larger than 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86485","name":"Skin test candida","description":"Skin test; candida","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73221","name":"Mri joint upr extrem w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35654","name":"Bpg axillary-femoral-femoral","description":"Bypass graft, with other than vein; axillary-femoral-femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1206.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82307","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26075","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0637","name":"Combination sit to stand sys","description":"Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54160","name":"Circumcision neonate","description":"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99411","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39401","name":"Mediastinoscpy w/medstnl bx","description":"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80198","name":"Assay of theophylline","description":"Theophylline","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22214","name":"Incis 1 vertebral seg lumbar","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62329","name":"Ther spi pnxr csf fluor/ct","description":"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or ct guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44366","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":62.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":716.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63664","name":"Revise spine eltrd plate","description":"Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23415","name":"Release of shoulder ligament","description":"Coracoacromial ligament release, with or without acromioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35666","name":"Bpg fem-ant tib pst tib/prnl","description":"Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1119.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24116","name":"Exc/crtg b1 cst/tum hum algr","description":"Excision or curettage of bone cyst or benign tumor, humerus; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80200","name":"Assay of tobramycin","description":"Tobramycin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22015","name":"I&d abscess p-spine l/s/ls","description":"Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":820.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21325","name":"Open tx nose fx uncomplicatd","description":"Open treatment of nasal fracture; uncomplicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87103","name":"Blood fungus culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33970","name":"Aortic circulation assist","description":"Insertion of intra-aortic balloon assist device through the femoral artery, open approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2384.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50547","name":"Laparo removal donor kidney","description":"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1381.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61321","name":"Crnec/crnot drg icr abs ittl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95133","name":"Immntx 4 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 4 stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27619","name":"Exc leg/ankle tum deep <5 cm","description":"Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34813","name":"Femoral endovas graft add-on","description":"Placement of femoral-femoral prosthetic graft during endovascular aortic aneurysm repair (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29894","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90865","name":"Narcosynthesis","description":"Narcosynthesis for psychiatric diagnostic and therapeutic purposes (eg, sodium amobarbital (amytal) interview)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86355","name":"B cells total count","description":"B cells, total count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64488","name":"Tap block bi injection","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25151","name":"Partial removal of radius","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1887.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49060","name":"Drain open retroperi abscess","description":"Drainage of retroperitoneal abscess, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76882","name":"Us lmtd jt/fcl evl nvasc xtr","description":"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21810","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","name":"Anes px male gent orchiopexy","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97607","name":"Neg prs wnd thr ndme<=50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72194","name":"Ct pelvis w/o & w/dye","description":"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25312","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; with tendon graft(s) (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50500","name":"Repair of kidney wound","description":"Nephrorrhaphy, suture of kidney wound or injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0397","name":"Alcohol/subs interv >30 min","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93563","name":"Njx cgen car cth slctv c ang","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33207","name":"Insert heart pm ventricular","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23040","name":"Arthrt gh jt expl/drg/rmv fb","description":"Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20900","name":"Removal of bone for graft","description":"Bone graft, any donor area; minor or small (eg, dowel or button)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0207T","name":"Clear eyelid gland w/heat","description":"Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80184","name":"Assay of phenobarbital","description":"Phenobarbital","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56606","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); each separate additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4652","name":"Microcapillary tube sealant","description":"Microcapillary tube sealant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0409","name":"Corf related serv 15 mins ea","description":"Social work and psychological services, directly relating to and/or furthering the patients rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"Psych diag eval w/med srvcs","description":"Psychiatric diagnostic evaluation with medical services","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86771","name":"Shigella antibody","description":"Antibody; shigella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52345","name":"Cysto/uretero w/up stricture","description":"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86156","name":"Cold agglutinin screen","description":"Cold agglutinin; screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42140","name":"Excision of uvula","description":"Uvulectomy, excision of uvula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22551","name":"Arthrd ant ntrbdy cervical","description":"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below c2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1524.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45550","name":"Repair rectum/remove sigmoid","description":"Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26255","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27632","name":"Exc leg/ankle les sc 3 cm/>","description":"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94260","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25575","name":"Optx rdl&uln shft fx rds&uln","description":"Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius and ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21143","name":"Rcnstj mdface lefort i 3/>pc","description":"Reconstruction midface, lefort i; 3 or more pieces, segment movement in any direction, without bone graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1140.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21081","name":"Impres&prep mndbl res prosth","description":"Impression and custom preparation; mandibular resection prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20979","name":"Lw ntsty us stimj bone healg","description":"Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27420","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; (eg, hauser type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57531","name":"Removal of cervix radical","description":"Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1248.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67430","name":"Explore/treat eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94453","name":"Hast w/suppl oxygen titrj","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23156","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74246","name":"X-ray xm upr gi trc 2cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11308","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91013","name":"Esophgl motil w/stim/perfus","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83775","name":"Assay malate dehydrogenase","description":"Malate dehydrogenase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0868","name":"Pwc gp 4 std seat/back","description":"Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35695","name":"Art trnsposj carotid subclav","description":"Transposition and/or reimplantation; carotid to subclavian artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":904.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92358","name":"Aphakia prosth service temp","description":"Prosthesis service for aphakia, temporary (disposable or loan, including materials)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77338","name":"Design mlc device for imrt","description":"Multi-leaf collimator (mlc) device(s) for intensity modulated radiation therapy (imrt), design and construction per imrt plan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2523.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72114","name":"X-ray exam l-s spine bending","description":"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33422","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; open heart, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31625","name":"Bronchoscopy w/biopsy(s)","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28715","name":"Arthrodesis triple","description":"Arthrodesis; triple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64778","name":"Digit nerve surgery add-on","description":"Excision of neuroma; digital nerve, each additional digit (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87329","name":"Giardia ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; giardia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64702","name":"Revise finger/toe nerve","description":"Neuroplasty; digital, 1 or both, same digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58950","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11970","name":"Rplcmt tiss xpndr perm implt","description":"Replacement of tissue expander with permanent implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93543","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28476","name":"Prq skel fix metar fx w/mnpj","description":"Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35241","name":"Rpr blvsl vn grf ntrthrc w/b","description":"Repair blood vessel with vein graft; intrathoracic, with bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1243.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2738.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92511","name":"Nasopharyngoscopy","description":"Nasopharyngoscopy with endoscope (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21034","name":"Excise max/zygoma mal tumor","description":"Excision of malignant tumor of maxilla or zygoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92608","name":"Ex for speech device rx addl","description":"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95800","name":"Slp stdy unattended","description":"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96933","name":"Rcm i&r only 1st lesion","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; interpretation and report only, first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","name":"Anes clsd px shoulder joint","description":"Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43887","name":"Gstr rstcv px opn rmvl port","description":"Gastric restrictive procedure, open; removal of subcutaneous port component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2275.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0027","name":"Semen analysis","description":"Semen analysis; presence and/or motility of sperm excluding huhner","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4057.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29874","name":"Arthrs knee surg rmv loos/fb","description":"Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95004","name":"Perq tests w/alrgnc xtrcs","description":"Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82436","name":"Assay of urine chloride","description":"Chloride; urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21325","name":"Open tx nose fx uncomplicatd","description":"Open treatment of nasal fracture; uncomplicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35005","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, vertebral artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96161","name":"Caregiver health risk assmt","description":"Administration of caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0014","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; ambulatory detoxification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","name":"Anes px crv spn&cord sitting","description":"Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27395","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93241","name":"Xtrnl ecg rec>48hr<7d","description":"External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42894","name":"Revision of pharyngeal walls","description":"Resection of pharyngeal wall requiring closure with myocutaneous or fasciocutaneous flap or free muscle, skin, or fascial flap with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33953","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26645","name":"Treat thumb fracture","description":"Closed treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33617","name":"Repair single ventricle","description":"Repair of complex cardiac anomalies (eg, single ventricle) by modified fontan procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1881.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9560","name":"Tc99m labeled rbc","description":"Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","name":"Anes arthr/ndsc tot wrst rpl","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50951","name":"Endoscopy of ureter","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","name":"Anes spine manipulation","description":"Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30545","name":"Rpr choanal atresia trsnpltn","description":"Repair choanal atresia; transpalatine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67120","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; extraocular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4349.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27680","name":"Release of lower leg tendon","description":"Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29901","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with debridement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48148","name":"Removal of pancreatic duct","description":"Excision of ampulla of vater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43845","name":"Gastroplasty duodenal switch","description":"Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal switch)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67027","name":"Implant eye drug system","description":"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold); air and bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34842","name":"Endovasc visc aorta 2 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96002","name":"Dynamic surface emg","description":"Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00934","name":"Anes rad amp penis ingun lym","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal lymphadenectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82480","name":"Assay serum cholinesterase","description":"Cholinesterase; serum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":53.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61314","name":"Crnec/crnot ittl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1668.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33971","name":"Aortic circulation assist","description":"Removal of intra-aortic balloon assist device including repair of femoral artery, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88275","name":"Cytogenetics 100-300","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95833","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65285","name":"Repair of eye wound","description":"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":18.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90962","name":"Esrd serv 1 visit p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 1 face-to-face visit by a physician or other qualified health care professional per month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63197","name":"Lam w/cordotomy 1stg thrc","description":"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1562.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96912","name":"Photochemotherapy puva","description":"Photochemotherapy; psoralens and ultraviolet a (puva)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5706.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48105","name":"Resect/debride pancreas","description":"Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2356.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78266","name":"Gstr empt img sm bwl&colon","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31254","name":"Nsl/sins ndsc w/prtl ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","name":"Anes thrcm px pulm rescj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55450","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24530","name":"Cltx sprcndylr humeral fx wo","description":"Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32561","name":"Lyse chest fibrin init day","description":"Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); initial day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33745","name":"Tis cgen car anomal 1st shnt","description":"Transcatheter intracardiac shunt (tis) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84403","name":"Assay of total testosterone","description":"Testosterone; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35206","name":"Repair blood vessel dir uxtr","description":"Repair blood vessel, direct; upper extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86644","name":"Cmv antibody","description":"Antibody; cytomegalovirus (cmv)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47425","name":"Incision of bile duct","description":"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77469","name":"Io radiation tx management","description":"Intraoperative radiation treatment management","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4672","name":"Drainage ext line, dialysis","description":"Drainage extension line, sterile, for dialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29821","name":"Sho arthrs srg compl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","name":"Anes opn/arthr elb tot rplct","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33243","name":"Remove eltrd/thoracotomy","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1185.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67115","name":"Release encircling material","description":"Release of encircling material (posterior segment)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62005","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; compound or comminuted, extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93350","name":"Stress tte only","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9512","name":"Tc99m pertechnetate","description":"Technetium tc-99m pertechnetate, diagnostic, per millicurie","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11626","name":"Exc s/n/h/f/g mal+mrg >4 cm","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5844.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35638","name":"Bpg aortobi-iliac","description":"Bypass graft, with other than vein; aortobi-iliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36217","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1545.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15003","name":"Wound prep addl 100 cm","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27394","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, 1 leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27513","name":"Treatment of thigh fracture","description":"Open treatment of femoral supracondylar or transcondylar fracture with intercondylar extension, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8697.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34502","name":"Reconstruct vena cava","description":"Reconstruction of vena cava, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29086","name":"Application cast finger","description":"Application, cast; finger (eg, contracture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0127","name":"Trim nail(s)","description":"Trimming of dystrophic nails, any number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","name":"Anes opn lwr l/a/f rad rescj","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31256","name":"Exploration maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35226","name":"Repair blood vessel dir lxtr","description":"Repair blood vessel, direct; lower extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0243","name":"Toilet rail","description":"Toilet rail, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9552","name":"F18 fdg","description":"Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2042.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20974","name":"Estim aid bone healg n-invas","description":"Electrical stimulation to aid bone healing; noninvasive (nonoperative)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0250","name":"Md inr test revie inter mgmt","description":"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of servic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4248","name":"Chlorhexidine antisept","description":"Chlorhexidine containing antiseptic, 1 ml","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57800","name":"Dilation of cervical canal","description":"Dilation of cervical canal, instrumental (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43108","name":"Removal of esophagus","description":"Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation and anastomosis(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3730.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75893","name":"Venous sampling by catheter","description":"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51702","name":"Insert temp bladder cath","description":"Insertion of temporary indwelling bladder catheter; simple (eg, foley)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42226","name":"Lengthening of palate","description":"Lengthening of palate, and pharyngeal flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67917","name":"Repair eyelid defect","description":"Repair of ectropion; extensive (eg, tarsal strip operations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6393.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4874.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KC","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43855","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1420.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0166","name":"Extrnl counterpulse, per tx","description":"External counterpulsation, per treatment session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94619","name":"Exercise tst brncspsm wo ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; without electrocardiographic recording(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24430","name":"Rpr non/mal humerus wo graft","description":"Repair of nonunion or malunion, humerus; without graft (eg, compression technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":891.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58146","name":"Myomectomy abdom complex","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3530.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1860.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3677","name":"So hard plas stabili pre cst","description":"Shoulder orthosis, shoulder joint design, 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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22224","name":"Osteot dsc ant 1vrt sgm lmbr","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1380.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27860","name":"Fixation of ankle joint","description":"Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8185","name":"Flutter device","description":"Flutter device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55600","name":"Vesiculotomy","description":"Vesiculotomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01632","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0246","name":"Transfer tub rail attachment","description":"Transfer tub rail attachment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0191T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"Psych diagnostic evaluation","description":"Psychiatric diagnostic evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78496","name":"Heart first pass add-on","description":"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28104","name":"Removal of foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86789","name":"West nile virus antibody","description":"Antibody; west nile virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87516","name":"Hepatitis b dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis b virus, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23491","name":"Reinforce shoulder bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; proximal humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":859.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93452","name":"Left hrt cath w/ventrclgrphy","description":"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3745.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21049","name":"Excis uppr jaw cyst w/repair","description":"Excision of benign tumor or cyst of maxilla; requiring extra-oral osteotomy and partial maxillectomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78451","name":"Ht muscle image spect sing","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":439.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0884","name":"Pwc gp4 std mult pow opt s/b","description":"Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4500","name":"Below knee surgical stocking","description":"Surgical stockings below knee length, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25248","name":"Remove forearm foreign body","description":"Exploration with removal of deep foreign body, forearm or wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53215","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; male","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42180","name":"Repair lac palate<2 cm","description":"Repair, laceration of palate; up to 2 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54620","name":"Suspension of testis","description":"Fixation of contralateral testis (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01430","name":"Anes px veins knee&pop nos","description":"Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99201","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28060","name":"Partial removal foot fascia","description":"Fasciectomy, plantar fascia; partial (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33775","name":"Rpr tga atr bfl rmvl plm bnd","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with removal of pulmonary band","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1609.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33411","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2929.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41000","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90470","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1416.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44397","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5394.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","name":"Anes opn/arthrs knee jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15732","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":783.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28485","name":"Optx metatarsal fx each","description":"Open treatment of metatarsal fracture, includes internal fixation, when performed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28130","name":"Removal of ankle bone","description":"Talectomy (astragalectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45123","name":"Partial proctectomy","description":"Proctectomy, partial, without anastomosis, perineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90997","name":"Hemoperfusion","description":"Hemoperfusion (eg, with activated charcoal or resin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86148","name":"Anti-phospholipid antibody","description":"Anti-phosphatidylserine (phospholipid) antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0343","name":"Laparotomy islet cell transp","description":"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51102","name":"Drain bl w/cath insertion","description":"Aspiration of bladder; with insertion of suprapubic catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89050","name":"Body fluid cell count","description":"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1734.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93724","name":"Elec alys antitchycar pm sys","description":"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36254","name":"Ins cath ren art 2nd+ bilat","description":"Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, an","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1768.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50782","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of duplicated ureter to bladder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33368","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33750","name":"Shunt subclavian to pulm art","description":"Shunt; subclavian to pulmonary artery (blalock-taussig type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50398","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4583.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5012.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25125","name":"Remove/graft forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19535.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3917.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25370","name":"Revise radius or ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius or ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45110","name":"Removal of rectum","description":"Proctectomy; complete, combined abdominoperineal, with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1477.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21820","name":"Treat sternum fracture","description":"Closed treatment of sternum fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50686","name":"Measure ureter pressure","description":"Manometric studies through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41822","name":"Excision of gum lesion","description":"Excision of fibrous tuberosities, dentoalveolar structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45383","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92548","name":"Cdp-sot 6 cond w/i&r","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90912","name":"Bfb training 1st 15 min","description":"Biofeedback training, perineal muscles, anorectal or urethral sphincter, including emg and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83540","name":"Assay of iron","description":"Iron","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47015","name":"Lapt aspir&/njx hep prst cst","description":"Laparotomy, with aspiration and/or injection of hepatic parasitic (eg, amoebic or echinococcal) cyst(s) or abscess(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45990","name":"Surg dx exam anorectal","description":"Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55865","name":"Extensive prostate surgery","description":"Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96933","name":"Rcm i&r only 1st lesion","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; interpretation and report only, first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45307","name":"Proctosigmoidoscopy fb","description":"Proctosigmoidoscopy, rigid; with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1376.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72149","name":"Mri lumbar spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23616","name":"Optx prx hmrl fx fix rpr rpl","description":"Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; with proximal humeral prosthetic replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2591.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1748.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77051","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52315","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0179","name":"Md recertification hha pt","description":"Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66180","name":"Aqueous shunt eye w/graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24577","name":"Cltx humrl cndylr fx w/mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82725","name":"Assay of blood fatty acids","description":"Fatty acids, nonesterified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97014","name":"Electric stimulation therapy","description":"Application of a modality to 1 or more areas; electrical stimulation (unattended)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93985","name":"Dup-scan hemo compl bi std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46250","name":"Remove ext hem groups 2+","description":"Hemorrhoidectomy, external, 2 or more columns/groups","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74251","name":"X-ray xm sm int 2cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23405","name":"Incision of tendon & muscle","description":"Tenotomy, shoulder area; single tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53085","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41120","name":"Partial removal of tongue","description":"Glossectomy; less than one-half tongue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21137","name":"Rdctj forehead cntrg only","description":"Reduction forehead; contouring only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26449","name":"Release forearm/hand tendon","description":"Tenolysis, complex, extensor tendon, finger, including forearm, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92313","name":"C-lens fitg corneosclrl lens","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneoscleral lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94619","name":"Exercise tst brncspsm wo ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; without electrocardiographic recording(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C9113","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36598","name":"Inj w/fluor eval cv device","description":"Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83775","name":"Assay malate dehydrogenase","description":"Malate dehydrogenase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54408","name":"Repair multi-comp penis pros","description":"Repair of component(s) of a multi-component, inflatable penile prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95805","name":"Multiple sleep latency test","description":"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26508","name":"Release thumb contracture","description":"Release of thenar muscle(s) (eg, thumb contracture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33404","name":"Prepare heart-aorta conduit","description":"Construction of apical-aortic conduit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1517.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93662","name":"Intracardiac ecg (ice)","description":"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28340","name":"Resect enlarged toe tissue","description":"Reconstruction, toe, macrodactyly; soft tissue resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93288","name":"Interrog evl pm/ldls pm ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system, or leadless pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25077","name":"Resect forearm/wrist tum<3cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53025","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43611","name":"Excision of stomach lesion","description":"Excision, local; malignant tumor of stomach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84120","name":"Assay of urine porphyrins","description":"Porphyrins, urine; quantitation and fractionation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91052","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28002","name":"Treatment of foot infection","description":"Incision and drainage below fascia, with or without tendon sheath involvement, foot; single bursal space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","AU","AV","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4915.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80406","name":"Acth stimulation panel","description":"Acth stimulation panel; for 3 beta-hydroxydehydrogenase deficiency this panel must include the following: cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68815","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","name":"Anes opn/arthrs px elbw nos","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69633","name":"Rebuild eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [porp], total ossicular replacement prosthesis [torp])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3257","name":"Orth foot add charge split s","description":"Orthopedic footwear, additional charge for split size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47538","name":"Perq plmt bile duct stent","description":"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; existing ac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3303.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82938","name":"Gastrin test","description":"Gastrin after secretin stimulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81528","name":"Oncology colorectal scr","description":"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 dna markers (kras mutations, promoter methylation of ndrg4 and bmp3) and fecal hemoglobin, utilizing stool, algorithm reported as a positive or negative result","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37210","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36571","name":"Insert picvad cath","description":"Insertion of peripherally inserted central venous access device, with subcutaneous port; age 5 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15860","name":"Iv njx tst vasc flo flap/grf","description":"Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29875","name":"Arthrs knee surg synvct lmtd","description":"Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78414","name":"Non-imaging heart function","description":"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2647.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97039","name":"Unlisted modality","description":"Unlisted modality (specify type and time if constant attendance)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4535","name":"Disposable liner/shield/pad","description":"Disposable liner/shield/guard/pad/undergarment, for incontinence, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78452","name":"Ht muscle image spect mult","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or red","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88120","name":"Cytp urne 3-5 probes ea spec","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3179.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":796.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2753.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31080","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":39.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82633","name":"Desoxycorticosterone","description":"Desoxycorticosterone, 11-","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95872","name":"Ndl emg single fiber eltrd","description":"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50300","name":"Remove cadaver donor kidney","description":"Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75954","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70480","name":"Ct orbit/ear/fossa w/o dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92355","name":"Fitg spect lw vis cmpnd lens","description":"Fitting of spectacle mounted low vision aid; telescopic or other compound lens system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93503","name":"Insert/place heart catheter","description":"Insertion and placement of flow directed catheter (eg, swan-ganz) for monitoring purposes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65815","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4648","name":"Implantable tissue marker","description":"Tissue marker, implantable, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27045","name":"Exc hip/pelv tum deep 5 cm/>","description":"Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48548","name":"Fuse pancreas and bowel","description":"Pancreaticojejunostomy, side-to-side anastomosis (puestow-type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1392.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26670","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82710","name":"Fats/lipids feces quant","description":"Fat or lipids, feces; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57180","name":"Treat vaginal bleeding","description":"Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55400","name":"Repair of sperm duct","description":"Vasovasostomy, vasovasorrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32100","name":"Exploration of chest","description":"Thoracotomy; with exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96571","name":"Photodynamic tx addl 15 min","description":"Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (list separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20930","name":"Sp bone algrft morsel add-on","description":"Allograft, morselized, or placement of osteopromotive material, for spine surgery only (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274T","name":"Prq lamot/lam dcmpr crv/thrc","description":"Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, under indirect image guidance (eg, fluoroscopic, ct), single or multiple levels, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42953","name":"Repair throat esophagus","description":"Pharyngoesophageal repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49321","name":"Laparoscopy biopsy","description":"Laparoscopy, surgical; with biopsy (single or multiple)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80440","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92230","name":"Fluorescein angioscopy i&r","description":"Fluorescein angioscopy with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30420","name":"Reconstruction of nose","description":"Rhinoplasty, primary; including major septal repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43135","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1219.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90822","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64897","name":"Nrv grf mltst arm/leg <4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24115","name":"Exc/crtg b1 cst/tum hum agrf","description":"Excision or curettage of bone cyst or benign tumor, humerus; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33782","name":"Nikaidoh proc","description":"Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, nikaidoh procedure); without coronary ostium reimplantation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2820.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76826","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93313","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); placement of transesophageal probe only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86744","name":"Nocardia antibody","description":"Antibody; nocardia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32200","name":"Drain open lung lesion","description":"Pneumonostomy, with open drainage of abscess or cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":904.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27466","name":"Lengthening of thigh bone","description":"Osteoplasty, femur; lengthening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83519","name":"Ria nonantibody","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, ria)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","name":"Anes iper upr abd gstr px mo","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4211","name":"Supp for self-adm injections","description":"Supplies for self-administered injections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28740","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, single joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44370","name":"Small bowel endoscopy/stent","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93280","name":"Pm device progr eval dual","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62304","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87535","name":"Hiv-1 probe&reverse trnscrpj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61312","name":"Crnec/crnot sttl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5049.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55866","name":"Laps surg prst8ect rpbic rad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44322","name":"Colostomy with biopsies","description":"Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27286","name":"Arthrd hip jt sbtrchc osteot","description":"Arthrodesis, hip joint (including obtaining graft); with subtrochanteric osteotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20555","name":"Place ndl musc/tis for rt","description":"Placement of needles or catheters into muscle and/or soft tissue for subsequent interstitial radioelement application (at the time of or subsequent to the procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26418","name":"Repair finger tendon","description":"Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26568","name":"Lengthen metacarpal/finger","description":"Osteoplasty, lengthening, metacarpal or phalanx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2082","name":"Visit esketamine 56m or less","description":"Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self-administration, includes 2 hours post-administration observation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35473","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37191","name":"Ins endovas vena cava filtr","description":"Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42665","name":"Ligation of salivary duct","description":"Ligation salivary duct, intraoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8421","name":"Ready gradient sleev/glov","description":"Gradient pressure aid (sleeve and glove combination), ready made","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84112","name":"Eval amniotic fluid protein","description":"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 [pamg-1], placental protein 12 [pp12], alpha-fetoprotein), qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54530","name":"Removal of testis","description":"Orchiectomy, radical, for tumor; inguinal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64480","name":"Njx aa&/strd tfrm epi c/t ea","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), cervical or thoracic, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29260","name":"Strapping of elbow or wrist","description":"Strapping; elbow or wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93642","name":"Ep evl 1/2chmb trnsvns cvdfb","description":"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parame","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61531","name":"Implant brain electrodes","description":"Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29886","name":"Arthrs knee surg drlg od les","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37250","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33315","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1662.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4248","name":"Chlorhexidine antisept","description":"Chlorhexidine containing antiseptic, 1 ml","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63278","name":"Bx/exc xdrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1450.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1206.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95981","name":"Io anal gast n-stim subsq","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1882.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59000","name":"Amniocentesis diagnostic","description":"Amniocentesis; diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81276","name":"Kras gene addl variants","description":"Kras (kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61501","name":"Craniectomy f/osteomyelitis","description":"Craniectomy; for osteomyelitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1391.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93572","name":"Iv dop vel&/press c flo ea","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33962","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0208T","name":"Audiometry air only","description":"Pure tone audiometry (threshold), automated; air only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60605","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; with excision of carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1464.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6205","name":"Composite drsg > 48 sq in","description":"Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59620","name":"Attempted vbac delivery only","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49081","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96445","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","name":"Anes ivntl rad artl crtd/c","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46060","name":"I&d ischiorectal/ntrmrl absc","description":"Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50081","name":"Perq nl/pl lithotrp cplx>2cm","description":"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; complex (eg, stone[s] > 2 cm, branching stones, stones in multiple locations, ureter stones, co","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92071","name":"Contact lens fitting for tx","description":"Fitting of contact lens for treatment of ocular surface disease","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46900","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86813","name":"Hla typing a b or c","description":"Hla typing; a, b, or c, multiple antigens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43313","name":"Esophagoplasty congenital","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2265.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24586","name":"Optx partclr fx&/dislc elbow","description":"Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29891","name":"Arthr ank ostchn df tal&/tib","description":"Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27259","name":"Treat hip dislocation","description":"Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc); with femoral shaft shortening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1312.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68816","name":"Probe nl duct w/balloon","description":"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3895.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4035","name":"Enteral feed supp pump per d","description":"Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95887","name":"Musc tst done w/n tst nonext","description":"Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1539.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26392","name":"Repair/graft hand tendon","description":"Removal of synthetic rod and insertion of flexor tendon graft, hand or finger (includes obtaining graft), each rod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1309.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":319.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88177","name":"Cytp fna eval ea addl","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4660","name":"Sphyg/bp app w cuff and stet","description":"Sphygmomanometer/blood pressure apparatus with cuff and stethoscope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1216.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4333.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5960.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61581","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2177.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5603.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99454","name":"Rem mntr physiol param 16-30","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 16-30 days in a 30-day period","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91038","name":"Esoph imped funct test > 1hr","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0445","name":"Oximeter non-invasive","description":"Oximeter device for measuring blood oxygen levels non-invasively","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2291","name":"Planar back for ped size wc","description":"Back, planar, for pediatric size wheelchair including fixed attaching hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55250","name":"Removal of sperm duct(s)","description":"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64416","name":"Njx aa&/strd brch pl nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27446","name":"Revision of knee joint","description":"Arthroplasty, knee, condyle and plateau; medial or lateral compartment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61566","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2059.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10036","name":"Plmt sft tiss loclzj dev ea","description":"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92340","name":"Fit spectacles monofocal","description":"Fitting of spectacles, except for aphakia; monofocal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9955","name":"Inj perflexane lip micros,ml","description":"Injection, perflexane lipid microspheres, per ml","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69401","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43500","name":"Surgical opening of stomach","description":"Gastrotomy; with exploration or foreign body removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80069","name":"Renal function panel","description":"Renal function panel this panel must include the following: albumin (82040) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphorus inorganic (phosphate) (84100) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95962","name":"Electrode stim brain add-on","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76937","name":"Us guide vascular access","description":"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95251","name":"Cont gluc mntr analysis i&r","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1306.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29240","name":"Strapping of shoulder","description":"Strapping; shoulder (eg, velpeau)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61253","name":"Burr hole treph ittl uni/bi","description":"Burr hole(s) or trephine, infratentorial, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21337","name":"Closed tx septal&nose fx","description":"Closed treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1717","name":"Brachytx, non-str,hdr ir-192","description":"Brachytherapy source, non-stranded, high dose rate iridium-192, per source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19367","name":"Brst rcnstj 1 pdcl tram flap","description":"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1150.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64905","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; first stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87800","name":"Detect agnt mult dna direc","description":"Infectious agent detection by nucleic acid (dna or rna), multiple organisms; direct probe(s) technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0246","name":"Transfer tub rail attachment","description":"Transfer tub rail attachment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92618","name":"Ex for nonspeech dev rx add","description":"Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26170","name":"Removal of palm tendon each","description":"Excision of tendon, palm, flexor or extensor, single, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36516","name":"Apheresis immunoads slctv","description":"Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","name":"Anes upr gi ndsc px nos","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0399","name":"Home sleep test/type 3 porta","description":"Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61612","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95980","name":"Io anal gast n-stim init","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76813","name":"Ob us nuchal meas 1 gest","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92591","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62290","name":"Njx px discography lumbar","description":"Injection procedure for discography, each level; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90857","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86666","name":"Ehrlichia antibody","description":"Antibody; ehrlichia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86750","name":"Malaria antibody","description":"Antibody; plasmodium (malaria)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27734","name":"Repair lower leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia and fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74713","name":"Mri fetal ea addl gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22326","name":"Treat neck spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1338.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71551","name":"Mri chest w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27435","name":"Incision of knee joint","description":"Capsulotomy, posterior capsular release, knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31231","name":"Nasal endoscopy dx","description":"Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25670","name":"Optx rdcrpl/ntrcrpl dislc 1+","description":"Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46030","name":"Removal anal seton oth mrk","description":"Removal of anal seton, other marker","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96152","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52442","name":"Cysto ins trnsprstc implt ea","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63306","name":"Remov vert idrl bdy thrclmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93321","name":"Doppler echo f-up/lmtd std","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50800","name":"Implant ureter in bowel","description":"Ureteroenterostomy, direct anastomosis of ureter to intestine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40761","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (abbe-estlander type), including sectioning and inserting of pedicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87532","name":"Hhv-6 dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33877","name":"Thoracoabdominal graft","description":"Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3184.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33783","name":"Nikaidoh proc w/ostia implt","description":"Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, nikaidoh procedure); with reimplantation of 1 or both coronary ostia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3051.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5394.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15820","name":"Blepharoplasty lower eyelid","description":"Blepharoplasty, lower eyelid;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64831","name":"Repair of digit nerve","description":"Suture of digital nerve, hand or foot; 1 nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28110","name":"Part removal of metatarsal","description":"Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4539","name":"Reuse diaper/brief any size","description":"Incontinence product, diaper/brief, reusable, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28052","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; metatarsophalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81190","name":"Cstb gene known famil vrnt","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; known familial variant(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63005","name":"Remove spine lamina 1/2 lmbr","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except for spondylolisthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35621","name":"Bpg axillary-femoral","description":"Bypass graft, with other than vein; axillary-femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58301","name":"Remove intrauterine device","description":"Removal of intrauterine device (iud)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11626","name":"Exc s/n/h/f/g mal+mrg >4 cm","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40819","name":"Excise lip or cheek fold","description":"Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28525","name":"Treat toe fracture","description":"Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation, when performed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31576","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, flexible; with biopsy(ies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1803.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99606","name":"Mtms by pharm est 15 min","description":"Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; initial 15 minutes, established patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95808","name":"Polysom any age 1-3> param","description":"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67208","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35286","name":"Rpr blvsl grf oth/th vn lxtr","description":"Repair blood vessel with graft other than vein; lower extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83020","name":"Hemoglobin electrophoresis","description":"Hemoglobin fractionation and quantitation; electrophoresis (eg, a2, s, c, and/or f)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60220","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33983","name":"Replace vad intra w/bp","description":"Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2019.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80166","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6221","name":"Gauze > 48 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["AW","GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","name":"Anes vag px crv cerclage","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88387","name":"Macroscopic xm dsj&prep tiss","description":"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31291","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; sphenoid region","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69646","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86378","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51860","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67314","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21931","name":"Exc back les sc 3 cm/>","description":"Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99491","name":"Chrnc care mgmt phys 1st 30","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45346","name":"Sigmoidoscopy w/ablation","description":"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92082","name":"Intermediate visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on goldmann perimeter, or semiquantitative, automated suprathreshold screening program, humphrey suprathreshold automatic diagnostic test, octopus program 33)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25112","name":"Reremove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); recurrent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3656.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3043.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33771","name":"Rpr tga w/surg enlgmnt vsd","description":"Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; with surgical enlargement of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1900.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65410","name":"Biopsy of cornea","description":"Biopsy of cornea","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83540","name":"Assay of iron","description":"Iron","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1882.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33610","name":"Repair by enlargement","description":"Repair of complex cardiac anomalies (eg, single ventricle with subaortic obstruction) by surgical enlargement of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35493","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65110","name":"Removal of eye","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49061","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27365","name":"Resect femur/knee tumor","description":"Radical resection of tumor, femur or knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52344","name":"Cysto/uretero stricture tx","description":"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15170","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80197","name":"Assay of tacrolimus","description":"Tacrolimus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3213","name":"Benesch boot pair child","description":"Benesch boot, pair, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69320","name":"Rebuild outer ear canal","description":"Reconstruction external auditory canal for congenital atresia, single stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15360","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73706","name":"Ct angio lwr extr w/o&w/dye","description":"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20670","name":"Removal implant superficial","description":"Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28111","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; first metatarsal head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11597.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87390","name":"Hiv-1 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-1","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8428","name":"Ready gradient gauntlet","description":"Gradient pressure aid (gauntlet), ready made","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69450","name":"Eardrum revision","description":"Tympanolysis, transcanal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37213","name":"Thromblytic art/ven therapy","description":"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95887","name":"Musc tst done w/n tst nonext","description":"Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61510","name":"Crnec treph exc brn tum sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2004.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KC","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67924","name":"Repair eyelid defect","description":"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76814","name":"Ob us nuchal meas add-on","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63265","name":"Excise intraspinl lesion crv","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1512.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41827","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86343","name":"Leukocyte histamine release","description":"Leukocyte histamine release test (lhr)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45119","name":"Remove rectum w/reservoir","description":"Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, j-pouch), with diverting enterostomy when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1532.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33465","name":"Replace tricuspid valve","description":"Replacement, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2395.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2812.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3043.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62194","name":"Replace/irrigate catheter","description":"Replacement or irrigation, subarachnoid/subdural catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2054.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","name":"Anes upr lwr gi ndsc px","description":"Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28160","name":"Partial removal of toe","description":"Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96406","name":"Chemo intralesional over 7","description":"Chemotherapy administration; intralesional, more than 7 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92284","name":"Dx dark adaptation exam i&r","description":"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62258","name":"Replace brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9507","name":"In111 capromab","description":"Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57023","name":"I&d vaginal hematoma non-ob","description":"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25320","name":"Repair/revise wrist joint","description":"Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulotomy and open reduction) for carpal instability","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99378","name":"Hospice care supervision","description":"Supervision of a hospice patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4149","name":"Ef blenderized foods","description":"Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0246","name":"Followup eval of foot pt lop","description":"Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":762.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37230","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26370","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23455","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; with labral repair (eg, bankart procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24136","name":"Sequestrectomy radial h/n","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), radial head or neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61518","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2537.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1686.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57720","name":"Revision of cervix","description":"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2301.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3822.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8270","name":"Enuresis alarm","description":"Enuresis alarm, using auditory buzzer and/or vibration device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3827.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","name":"Anes px art knee&pop teaec","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61598","name":"Transpetrosal approach/skull","description":"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2588.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23935","name":"Inc dp opn b1 crtx hum/elbw","description":"Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), humerus or elbow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1373.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37252","name":"Intrvasc us noncoronary 1st","description":"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81513","name":"Nfct ds bv rna vag flu alg","description":"Infectious disease, bacterial vaginosis, quantitative real-time amplification of rna markers for atopobium vaginae, gardnerella vaginalis, and lactobacillus species, utilizing vaginal-fluid specimens, algorithm reported as a positive or negative result for bacterial vaginosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1790.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50120","name":"Pyelotomy w/exploration","description":"Pyelotomy; with exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75573","name":"Ct hrt c+ strux cgen hrt ds","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3d image postprocessing, assessment of left ventricular [lv] cardiac function, right ventricular [rv] structure and function and evaluation of ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99218","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66988","name":"Xcapsl ctrc rmvl w/ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic cyclophotocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65880","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4036","name":"Enteral feed sup kit grav by","description":"Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49412","name":"Ins device for rt guide open","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if performed, single or multiple (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31380","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); anterovertical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00326","name":"Anes all px larynx&trach<1yr","description":"Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11057","name":"Parng/cutg b9 hyprkr les >4","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than 4 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22318","name":"Treat odontoid fx w/o graft","description":"Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33218","name":"Repair lead pace-defib one","description":"Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9040","name":"Rbc leukoreduced irradiated","description":"Red blood cells, leukocytes reduced, irradiated, each unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49565","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20983","name":"Ablate bone tumor(s) perq","description":"Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; cryoablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7523.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50393","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","name":"Anes px nrv musc upr a&e nos","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87472","name":"Bartonella dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); bartonella henselae and bartonella quintana, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27880","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27110","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to greater trochanter of femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11441","name":"Exc face-mm b9+marg 0.6-1 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25800","name":"Arthrd wrist complete wo grf","description":"Arthrodesis, wrist; complete, without bone graft (includes radiocarpal and/or intercarpal and/or carpometacarpal joints)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70496","name":"Ct angiography head","description":"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24435","name":"Rpr non/mal hum with agrft","description":"Repair of nonunion or malunion, humerus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0236T","name":"Trluml perip athrc abd aorta","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; abdominal aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9507.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52283","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with steroid injection into stricture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31528","name":"Laryngoscopy and dilation","description":"Laryngoscopy direct, with or without tracheoscopy; with dilation, initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11011","name":"Debride skin musc at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, and muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55720","name":"Drainage of prostate abscess","description":"Prostatotomy, external drainage of prostatic abscess, any approach; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78831","name":"Rp loclzj tum spect 2 areas","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1317.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1010.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1606.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0087","name":"Care man home care plan 60 m","description":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8584.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44364","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46280","name":"Remove anal fist complex","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93668","name":"Peripheral vascular rehab","description":"Peripheral arterial disease (pad) rehabilitation, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98942","name":"Chiropractic manj 5 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 5 regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88162","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95934","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20150","name":"Excision epiphyseal bar","description":"Excision of epiphyseal bar, with or without autogenous soft tissue graft obtained through same fascial incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0555","name":"Humidifier for use w/ regula","description":"Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19282","name":"Perq device breast ea imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including mammographic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78815","name":"Pet image w/ct skull-thigh","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; skull base to mid-thigh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99360","name":"Physician standby services","description":"Standby service, requiring prolonged attendance, each 30 minutes (eg, operative standby, standby for frozen section, for cesarean/high risk delivery, for monitoring eeg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4305","name":"Drug delivery system >=50 ml","description":"Disposable drug delivery system, flow rate of 50 ml or greater per hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13150","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82626","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone (dhea)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22327","name":"Treat thorax spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1341.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58605","name":"Division of fallopian tube","description":"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1588.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17108","name":"Dstr cut vsc prlf les>50sqcm","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); over 50.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43268","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5976.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25400","name":"Repair radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; without graft (eg, compression technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3530.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8644.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72147","name":"Mri chest spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33781","name":"Rpr tga rcnstj rpr sbpl obst","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with repair of subpulmonic obstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2017.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26700","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26433","name":"Repair finger tendon","description":"Repair of extensor tendon, distal insertion, primary or secondary; without graft (eg, mallet finger)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57720","name":"Revision of cervix","description":"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82978","name":"Assay of glutathione","description":"Glutathione","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"Esrd srv 2-3 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per m","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77051","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6022","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90467","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3960.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33949","name":"Ecmo/ecls daily mgmt artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; daily management, each day, veno-arterial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29897","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1189.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22865","name":"Rmvl tot arthrp 1ntrspc lmbr","description":"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2064.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4160","name":"Ef ped caloric dense>/=0.7kc","description":"Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35566","name":"Art byp fem-ant-post tib/prl","description":"Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1474.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22532","name":"Arthrd lat xtrcvtry tq thrc","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1603.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32810","name":"Close chest after drainage","description":"Closure of chest wall following open flap drainage for empyema (clagett type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21172","name":"Rcnst supr-lat orb rm&lw fhd","description":"Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1899.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66682","name":"Repair iris & ciliary body","description":"Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, mccannel suture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80190","name":"Assay of procainamide","description":"Procainamide;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68320","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with conjunctival graft or extensive rearrangement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67334","name":"Revise eye muscle w/suture","description":"Strabismus surgery by posterior fixation suture technique, with or without muscle recession (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77777","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37766","name":"Phleb veins - extrem 20+","description":"Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71271","name":"Ct thorax lung cancer scr c-","description":"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36253","name":"Ins cath ren art 2nd+ unilat","description":"Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, an","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34471","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; subclavian vein, by neck incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82013","name":"Acetylcholinesterase assay","description":"Acetylcholinesterase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27151","name":"Incision of hip bones","description":"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75900","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86367","name":"Stem cells total count","description":"Stem cells (ie, cd34), total count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","name":"Anes px crv spn&cord sitting","description":"Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95934","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11102","name":"Tangntl bx skin single les","description":"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27766","name":"Optx medial ankle fx","description":"Open treatment of medial malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12018","name":"Rpr f/e/e/n/l/m >30.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95725","name":"Eeg phy/qhp>84 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of eeg recording, without video","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S1040","name":"Cranial remolding orthosis","description":"Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33611","name":"Repair double ventricle","description":"Repair of double outlet right ventricle with intraventricular tunnel repair;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1698.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92070","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27218","name":"Treat pelvic ring fracture","description":"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes ipsilateral ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9041","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35045","name":"Repair defect of arm artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, radial or ulnar artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1311.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","name":"Anes px vn knee&pop av fstl","description":"Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93453","name":"R&l hrt cath w/ventriclgrphy","description":"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0274","name":"Over-bed table","description":"Over-bed table","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2873.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57540","name":"Removal of residual cervix","description":"Excision of cervical stump, abdominal approach;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76000","name":"Fluoroscopy <1 hr phys/qhp","description":"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55705","name":"Bx prst8 any approach nonimg","description":"Biopsy, prostate, any approach, nonimaging-guided","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76880","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4535","name":"Disposable liner/shield/pad","description":"Disposable liner/shield/guard/pad/undergarment, for incontinence, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83905","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33363","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open axillary artery approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47600","name":"Cholecystectomy","description":"Cholecystectomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34708","name":"Evasc rpr ilio-iliac rpt","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1620.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46045","name":"I&d absc tranal under anes","description":"Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52277","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with resection of external sphincter (sphincterotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33774","name":"Rpr tga atrial baffle px","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52317","name":"Remove bladder stone","description":"Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21462","name":"Optx mndblr fx w/ntrdntl","description":"Open treatment of mandibular fracture; with interdental fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1743.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82507","name":"Assay of citrate","description":"Citrate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28192","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; deep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50940","name":"Release of ureter","description":"Deligation of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51570","name":"Removal of bladder","description":"Cystectomy, complete; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38720","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (complete)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26490","name":"Revise thumb tendon","description":"Opponensplasty; superficialis tendon transfer type, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82487","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82164","name":"Angiotensin i enzyme test","description":"Angiotensin i - converting enzyme (ace)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81179","name":"Atxn2 gene detc abnor allele","description":"Atxn2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24160","name":"Rmvl prosthhumrl&ulnar cmpnt","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and ulnar components","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23170","name":"Sequestrectomy clavicle","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), clavicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62326","name":"Njx interlaminar lmbr/sac","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0425","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1624.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","22"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35637","name":"Bpg aortoiliac","description":"Bypass graft, with other than vein; aortoiliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1467.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5394.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86641","name":"Cryptococcus antibody","description":"Antibody; cryptococcus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26180","name":"Removal of finger tendon","description":"Excision of tendon, finger, flexor or extensor, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2102.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95715","name":"Veeg ea 12-26hr intmt mntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, each increment of 12-26 hours; with intermittent monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3464.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69140","name":"Remove ear canal lesion(s)","description":"Excision exostosis(es), external auditory canal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41120","name":"Partial removal of tongue","description":"Glossectomy; less than one-half tongue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90853","name":"Group psychotherapy","description":"Group psychotherapy (other than of a multiple-family group)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86000","name":"Agglutinins febrile antigen","description":"Agglutinins, febrile (eg, brucella, francisella, murine typhus, q fever, rocky mountain spotted fever, scrub typhus), each antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42106","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with simple primary closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43644","name":"Lap gastric bypass/roux-en-y","description":"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and roux-en-y gastroenterostomy (roux limb 150 cm or less)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92133","name":"Cptrzd oph dx img pst sgm on","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; optic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95024","name":"Iq tests w/allergenic xtrcs","description":"Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58285","name":"Extensive hysterectomy","description":"Vaginal hysterectomy, radical (schauta type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31032","name":"Explore sinus remove polyps","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) with removal of antrochoanal polyps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22600","name":"Arthrd pst tq 1ntrspc crv","description":"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below c2 segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54360","name":"Penis plastic surgery","description":"Plastic operation on penis to correct angulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34709","name":"Plmt xtn prosth evasc rpr","description":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselec","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53520","name":"Repair of urethra defect","description":"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93662","name":"Intracardiac ecg (ice)","description":"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44660","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; without intestinal or bladder resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37203","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65760","name":"Keratomileusis","description":"Keratomileusis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92520","name":"Laryngeal function studies","description":"Laryngeal function studies (ie, aerodynamic testing and acoustic testing)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57240","name":"Anterior colporrhaphy","description":"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19316","name":"Mastopexy","description":"Mastopexy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23221","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57456","name":"Endocerv curettage w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8052.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21925","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; deep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33870","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38794","name":"Access thoracic lymph duct","description":"Cannulation, thoracic duct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50405","name":"Revision of kidney/ureter","description":"Pyeloplasty (foley y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital kidney abnormality, secondary pyeloplasty, solitary kidney, calycoplasty)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1128.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92979","name":"Endoluminl ivus oct c ea","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to co","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27246","name":"Treat thigh fracture","description":"Closed treatment of greater trochanteric fracture, without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80408","name":"Aldosterone suppression eval","description":"Aldosterone suppression evaluation panel (eg, saline infusion) this panel must include the following: aldosterone (82088 x 2) renin (84244 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48545","name":"Pancreatorrhaphy","description":"Pancreatorrhaphy for injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1128.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90816","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0288","name":"Recon, cta for surg plan","description":"Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28293","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0402","name":"Initial preventive exam","description":"Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67825","name":"Revise eyelashes","description":"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84166","name":"Protein e-phoresis/urine/csf","description":"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, csf)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12767.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21013","name":"Exc face tum deep < 2 cm","description":"Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); less than 2 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3461.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70559","name":"Mri brain w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41006","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15201","name":"Fth/gft fr trnk each addl","description":"Full thickness graft, free, including direct closure of donor site, trunk; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31576","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, flexible; with biopsy(ies)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50325","name":"Prep donor renal graft","description":"Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches, as necessary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1762.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76377","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88285","name":"Chromosome count additional","description":"Chromosome analysis; additional cells counted, each study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01758","name":"Anes opn/arthrs elbw exc cst","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; excision of cyst or tumor of humerus","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27060","name":"Removal of ischial bursa","description":"Excision; ischial bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62365","name":"Remove spine infusion device","description":"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86709","name":"Hepatitis a igm antibody","description":"Hepatitis a antibody (haab), igm antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28405","name":"Cltx calcaneal fx w/mnpj","description":"Closed treatment of calcaneal fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44650","name":"Repair bowel fistula","description":"Closure of enteroenteric or enterocolic fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1166.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93583","name":"Perq transcath septal reduxn","description":"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81344","name":"Tbp gene detc abnor alleles","description":"Tbp (tata box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93459","name":"L hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter place","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93640","name":"Ep eval 1/2chmbr pacg cvdfb","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76882","name":"Us lmtd jt/fcl evl nvasc xtr","description":"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0327","name":"Colon ca scrn;bld-bsd biomrk","description":"Colorectal cancer screening; blood-based biomarker","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93308","name":"Tte f-up or lmtd","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4531","name":"Ped size pull-on sm/med","description":"Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","name":"Anes hrna rpr upr abd nos","description":"Anesthesia for hernia repairs in upper abdomen; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93922","name":"Upr/l xtremity art 2 levels","description":"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waveform recording and analysis at 1-2 levels, or ankle/brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33889","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69706","name":"Nps surg dilat eust tube bi","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88368","name":"Insitu hybridization manual","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86708","name":"Hepatitis a antibody","description":"Hepatitis a antibody (haab)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44379","name":"S bowel endoscope w/stent","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28805","name":"Amputation thru metatarsal","description":"Amputation, foot; transmetatarsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23184","name":"Prtl excision bone prox hum","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), proximal humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97163","name":"Pt eval high complex 45 min","description":"Physical therapy evaluation: high complexity, requiring these components: a history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; an examination of body systems using standardized tests and measures addressing a total of 4 or more elements from","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82552","name":"Assay of cpk in blood","description":"Creatine kinase (ck), (cpk); isoenzymes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0049","name":"Alcohol/drug screening","description":"Alcohol and/or drug screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55700","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89329","name":"Sperm evaluation test","description":"Sperm evaluation; hamster penetration test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91110","name":"Gi trc img intral esoph-ile","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25251","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; complicated, including total wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61070","name":"Brain canal shunt procedure","description":"Puncture of shunt tubing or reservoir for aspiration or injection procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2317.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53410","name":"Reconstruction of urethra","description":"Urethroplasty, 1-stage reconstruction of male anterior urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98962","name":"Edu&trn pt slf-mgmt nqhp 5-8","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 5-8 patients","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33241","name":"Remove pulse generator","description":"Removal of implantable defibrillator pulse generator only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27724","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1067.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70546","name":"Mr angiograph head w/o&w/dye","description":"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50961","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86148","name":"Anti-phospholipid antibody","description":"Anti-phosphatidylserine (phospholipid) antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27691","name":"Revise lower leg tendon","description":"Transfer or transplant of single tendon (with muscle redirection or rerouting); deep (eg, anterior tibial or posterior tibial through interosseous space, flexor digitorum longus, flexor hallucis longus, or peroneal tendon to midfoot or hindfoot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17276","name":"Dstr mal les s/n/h/f/g >4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85370","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95830","name":"Insert electrodes for eeg","description":"Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (eeg) recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27179","name":"Revise head/neck of femur","description":"Open treatment of slipped femoral epiphysis; osteoplasty of femoral neck (heyman type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87797","name":"Detect agent nos dna dir","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; direct probe technique, each organism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0106T","name":"Touch quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using touch pressure stimuli to assess large diameter sensation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93280","name":"Pm device progr eval dual","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88240","name":"Cell cryopreserve/storage","description":"Cryopreservation, freezing and storage of cells, each cell line","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26115","name":"Exc hand les sc < 1.5 cm","description":"Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; less than 1.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62190","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87003","name":"Small animal inoculation","description":"Animal inoculation, small animal, with observation and dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27842","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85396","name":"Clotting assay whole blood","description":"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32604","name":"Thoracoscopy wbx sac","description":"Thoracoscopy, diagnostic (separate procedure); pericardial sac, with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28107","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73720","name":"Mri lwr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0398","name":"Home sleep test/type 2 porta","description":"Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22224","name":"Osteot dsc ant 1vrt sgm lmbr","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1380.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58671","name":"Laparoscopy tubal block","description":"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or falope ring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93313","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); placement of transesophageal probe only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0871","name":"Pwc gp 4 vhd seat/back","description":"Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27501","name":"Treatment of thigh fracture","description":"Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78593","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94775","name":"Ped home apnea mntr att only","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; monitor attachment only (includes hook-up, initiation of recording and disconnection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0436","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92517","name":"Vemp test i&r cervical","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; cervical (cvemp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72133","name":"Ct lumbar spine w/o & w/dye","description":"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83698","name":"Assay lipoprotein pla2","description":"Lipoprotein-associated phospholipase a2 (lp-pla2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96150","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27355","name":"Remove femur lesion","description":"Excision or curettage of bone cyst or benign tumor of femur;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77338","name":"Design mlc device for imrt","description":"Multi-leaf collimator (mlc) device(s) for intensity modulated radiation therapy (imrt), design and construction per imrt plan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29855","name":"Tibial arthroscopy/surgery","description":"Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86337","name":"Insulin antibodies","description":"Insulin antibodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31615","name":"Trcheobrnchsc est trachs inc","description":"Tracheobronchoscopy through established tracheostomy incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01820","name":"Anes clsd px rds u/w/h bones","description":"Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87650","name":"Strep a dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3371.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92627","name":"Eval aud funcj ea addl 15","description":"Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55041","name":"Removal of hydroceles","description":"Excision of hydrocele; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29884","name":"Arthrs knee surg lysis ads","description":"Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82013","name":"Acetylcholinesterase assay","description":"Acetylcholinesterase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76828","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2515.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28285","name":"Repair of hammertoe","description":"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97033","name":"App mdlty 1+iontphrsis ea 15","description":"Application of a modality to 1 or more areas; iontophoresis, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31536","name":"Laryngoscopy w/bx & op scope","description":"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74270","name":"X-ray xm colon 1cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77371","name":"Srs multisource","description":"Radiation treatment delivery, stereotactic radiosurgery (srs), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source cobalt 60 based","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92556","name":"Speech audiometry complete","description":"Speech audiometry threshold; with speech recognition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87491","name":"Chlmyd trach dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35539","name":"Art byp grft aortofemoral","description":"Bypass graft, with vein; aortofemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1942.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37243","name":"Vasc embolize/occlude organ","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87260","name":"Adenovirus ag if","description":"Infectious agent antigen detection by immunofluorescent technique; adenovirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77525","name":"Proton treatment complex","description":"Proton treatment delivery; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88154","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61557","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; bifrontal bone flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9983","name":"Remote e/m est. pt 10mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a problem focused history; a problem","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42844","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with local flap (eg, tongue, buccal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67560","name":"Revise eye socket implant","description":"Orbital implant (implant outside muscle cone); removal or revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67413","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87621","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4681.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27043","name":"Exc hip pelvis les sc 3 cm/>","description":"Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11950","name":"Subq njx filling matrl 1cc/<","description":"Subcutaneous injection of filling material (eg, collagen); 1 cc or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2322.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75676","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99251","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40701","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88385","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49590","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95921","name":"Autonomic nrv parasym inervj","description":"Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded r-r interval, valsalva ratio, and 30:15 ratio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49421","name":"Ins tun ip cath for dial opn","description":"Insertion of tunneled intraperitoneal catheter for dialysis, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0460","name":"Autolog prp not diab ulcer","description":"Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedures, administration and dressings, per treatment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27395","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9901","name":"Delivery/set up/dispensing","description":"Dme delivery, set up, and/or dispensing service component of another hcpcs code","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85360","name":"Euglobulin lysis","description":"Euglobulin lysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95070","name":"Inhlj brncl challenge tstg","description":"Inhalation bronchial challenge testing (not including necessary pulmonary function tests), with histamine, methacholine, or similar compounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85046","name":"Reticyte/hgb concentrate","description":"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content [chr], immature reticulocyte fraction [irf], reticulocyte volume [mrv], rna content), direct measurement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2251","name":"Brief chkin, 5-10, non-e/m","description":"Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36572","name":"Insj picc rs&i <5 yr","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; younger than 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52275","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; male","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96127","name":"Brief emotional/behav assmt","description":"Brief emotional/behavioral assessment (eg, depression inventory, attention-deficit/hyperactivity disorder [adhd] scale), with scoring and documentation, per standardized instrument","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42305","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15136","name":"Drm agrft f/s/n/h/f/g/m ea","description":"Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54065","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55450","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28114","name":"Removal of metatarsal heads","description":"Ostectomy, complete excision; all metatarsal heads, with partial proximal phalangectomy, excluding first metatarsal (eg, clayton type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15620","name":"Delay flap f/c/c/n/ax/g/h/f","description":"Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97168","name":"Ot re-eval est plan care","description":"Re-evaluation of occupational therapy established plan of care, requiring these components: an assessment of changes in patient functional or medical status with revised plan of care; an update to the initial occupational profile to reflect changes in condition or environment that affect future inte","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31239","name":"Nsl/sinus endoscopy surg dcr","description":"Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34471","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; subclavian vein, by neck incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65220","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, without slit lamp","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3230","name":"Custom shoes depth inlay","description":"Orthopedic footwear, custom shoe, depth inlay, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33762","name":"Shunt desc aorta to pulm art","description":"Shunt; descending aorta to pulmonary artery (potts-smith type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43240","name":"Egd w/transmural drain cyst","description":"Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheter[s]/stent[s], when performed, and endoscopic ultrasound, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22857","name":"Tot disc arthrp 1ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); single interspace, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83970","name":"Assay of parathormone","description":"Parathormone (parathyroid hormone)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4978.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1779.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82375","name":"Assay carboxyhb quant","description":"Carboxyhemoglobin; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","name":"Anes opn/arthrs px elbw nos","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67042","name":"Vit for macular hole","description":"Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31030","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) without removal of antrochoanal polyps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50955","name":"Ureter endoscopy & biopsy","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75722","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33924","name":"Remove pulmonary shunt","description":"Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67043","name":"Vit for membrane dissect","description":"Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and laser photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0197T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87650","name":"Strep a dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28760","name":"Fusion of big toe joint","description":"Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great toe, interphalangeal joint (eg, jones type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28545","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72270","name":"Myelogphy 2/> spine regions","description":"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00934","name":"Anes rad amp penis ingun lym","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal lymphadenectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87329","name":"Giardia ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; giardia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31513","name":"Injection into vocal cord","description":"Laryngoscopy, indirect; with vocal cord injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50630","name":"Removal of ureter stone","description":"Ureterolithotomy; lower one-third of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95852","name":"Range of motion measurements","description":"Range of motion measurements and report (separate procedure); hand, with or without comparison with normal side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49904","name":"Omental flap extra-abdom","description":"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3255","name":"Orth foot non-standard size/","description":"Non-standard size or length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87810","name":"Chlmyd trach assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; chlamydia trachomatis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2204.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77417","name":"Ther radiology port image(s)","description":"Therapeutic radiology port image(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67005","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67900","name":"Repair brow defect","description":"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","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, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27842","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2723.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15600","name":"Delay flap trunk","description":"Delay of flap or sectioning of flap (division and inset); at trunk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99464","name":"Attendance at delivery","description":"Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1860.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2525.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33476","name":"Revision of heart chamber","description":"Right ventricular resection for infundibular stenosis, with or without commissurotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1319.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92225","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27098","name":"Transfer tendon to pelvis","description":"Transfer, adductor to ischium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21280","name":"Medial canthopexy","description":"Medial canthopexy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57454","name":"Bx/curett of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99190","name":"Special pump services","description":"Assembly and operation of pump with oxygenator or heat exchanger (with or without ecg and/or pressure monitoring); each hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24666","name":"Optx radial head/nck fx rplc","description":"Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed; with radial head prosthetic replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27052","name":"Biopsy of hip joint","description":"Arthrotomy, with biopsy; hip joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64632","name":"N block inj common digit","description":"Destruction by neurolytic agent; plantar common digital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82960","name":"Test for g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87380","name":"Hepatitis delta agent ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis, delta agent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","name":"Anes iper upr abd pncrtect","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, whipple procedure)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2066","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25310","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4928","name":"Surgical mask","description":"Surgical mask, per 20","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1906.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85260","name":"Clot factor x stuart-power","description":"Clotting; factor x (stuart-prower)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"Patient recorded spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; includes reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibration and review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62201","name":"Brain cavity shunt w/scope","description":"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37246","name":"Trluml balo angiop 1st art","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80197","name":"Assay of tacrolimus","description":"Tacrolimus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27394","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, 1 leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":329.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1358.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","KM","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59300","name":"Episiotomy or vaginal repair","description":"Episiotomy or vaginal repair, by other than attending","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23650","name":"Cltx sho dslc w/mnpj wo anes","description":"Closed treatment of shoulder dislocation, with manipulation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47544","name":"Removal duct glbldr calculi","description":"Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation (list sep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95165","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of doses)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24134","name":"Sequestrectomy shft/dstl hum","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80305","name":"Drug test prsmv dir opt obs","description":"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6006","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43645","name":"Lap gastr bypass incl smll i","description":"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1550.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01953","name":"Anes 2&3 burn ea add 9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; each additional 9% total body surface area or part thereof (list separately in addition to code for primary procedur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26820","name":"Thumb fusion with graft","description":"Fusion in opposition, thumb, with autogenous graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23195","name":"Resection humeral head","description":"Resection, humeral head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33775","name":"Rpr tga atr bfl rmvl plm bnd","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with removal of pulmonary band","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1609.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33521","name":"Cabg artery-vein four","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 4 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6246.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86141","name":"C-reactive protein hs","description":"C-reactive protein; high sensitivity (hscrp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86671","name":"Fungus nes antibody","description":"Antibody; fungus, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78072","name":"Parathyrd planar w/spect&ct","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect), and concurrently acquired computed tomography (ct) for anatomical localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52276","name":"Cystoscopy and treatment","description":"Cystourethroscopy with direct vision internal urethrotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38215","name":"Harvest stem cell concentrte","description":"Transplant preparation of hematopoietic progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58552","name":"Laparo-vag hyst incl t/o","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20937","name":"Sp bone agrft morsel add-on","description":"Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43241","name":"Egd tube/cath insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2249.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4714","name":"Treated water per gallon","description":"Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76102","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93784","name":"Ambl bp mntr w/software","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; including recording, scanning analysis, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81183","name":"Atxn10 gene detc abnor allel","description":"Atxn10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2088","name":"Off base opioid tx, add30","description":"Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; each additional 30 minutes beyond the first 120 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82120","name":"Amines vaginal fluid qual","description":"Amines, vaginal fluid, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99492","name":"1st psyc collab care mgmt","description":"Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0322","name":"Home h physio data collec tr","description":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e., remote patient monitoring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11010","name":"Debride skin at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin and subcutaneous tissues","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28288","name":"Partial removal of foot bone","description":"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88309","name":"Tissue exam by pathologist","description":"Level vi - surgical pathology, gross and microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection extremity, disarticulation fetus, with dissection larynx, partial/total resect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77326","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99480","name":"Sbsq ic inf pbw 2,501-5,000","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2,501-5,000 grams)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82489","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":964.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50365","name":"Rnl altrnsplj w/rcp nfrct","description":"Renal allotransplantation, implantation of graft; with recipient nephrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2498.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67700","name":"Blepharotomy drg absc eyelid","description":"Blepharotomy, drainage of abscess, eyelid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3209","name":"Surgical boot each child","description":"Surgical boot, each, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87555","name":"M.tuberculo dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57289","name":"Repair bladder & vagina","description":"Pereyra procedure, including anterior colporrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83825","name":"Assay of mercury","description":"Mercury, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2072.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1582.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31292","name":"Nsl/sins ndsc med/inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial or inferior wall","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"Office o/p est low 20 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or e","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93580","name":"Transcath closure of asd","description":"Percutaneous transcatheter closure of congenital interatrial communication (ie, fontan fenestration, atrial septal defect) with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83003","name":"Assay growth hormone (hgh)","description":"Growth hormone, human (hgh) (somatotropin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87275","name":"Influenza b ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza b virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31605","name":"Emer tracheostomy cthyr mem","description":"Tracheostomy, emergency procedure; cricothyroid membrane","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29105","name":"Application long arm splint","description":"Application of long arm splint (shoulder to hand)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21510","name":"Inc deep opng b1 crtx thorax","description":"Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), thorax","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308T","name":"Insj ocular telescope prosth","description":"Insertion of ocular telescope prosthesis including removal of crystalline lens or intraocular lens prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27832","name":"Treat lower leg dislocation","description":"Open treatment of proximal tibiofibular joint dislocation, includes internal fixation, when performed, or with excision of proximal fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92060","name":"Sensorimotor examination","description":"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15221","name":"Fth/gft fr s/a/l each addl","description":"Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59074","name":"Fetal fluid drainage w/us","description":"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95120","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; single injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64445","name":"Njx aa&/strd sciatic nrv img","description":"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36510","name":"Insertion of catheter vein","description":"Catheterization of umbilical vein for diagnosis or therapy, newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88150","name":"Cytopath c/v manual","description":"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88152","name":"Cytopath c/v auto redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77071","name":"Mnl appl strs jt radiography","description":"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0700","name":"Safety equipment","description":"Safety equipment, device or accessory, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40844","name":"Reconstruction of mouth","description":"Vestibuloplasty; entire arch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1870.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65778","name":"Cover eye w/membrane","description":"Placement of amniotic membrane on the ocular surface; without sutures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82491","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36563","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device with subcutaneous pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93459","name":"L hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter place","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24357","name":"Repair elbow perc","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93464","name":"Exercise w/hemodynamic meas","description":"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2887.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78430","name":"Myocrd img pet rst/strs w/ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50605","name":"Insert ureteral support","description":"Ureterotomy for insertion of indwelling stent, all types","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32655","name":"Thoracoscopy resect bullae","description":"Thoracoscopy, surgical; with resection-plication of bullae, includes any pleural procedure when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99439","name":"Chrnc care mgmt staf ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75893","name":"Venous sampling by catheter","description":"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58954","name":"Tah rad debulk/lymph remove","description":"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1381.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99170","name":"Anogenital exam child w imag","description":"Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3733.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61321","name":"Crnec/crnot drg icr abs ittl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55880","name":"Abltj mal prst8 tiss hifu","description":"Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47765","name":"Fuse liver ducts & bowel","description":"Anastomosis, of intrahepatic ducts and gastrointestinal tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2559.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87912","name":"Nfct agt gntyp alys hep b","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hepatitis b virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27788","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64702","name":"Revise finger/toe nerve","description":"Neuroplasty; digital, 1 or both, same digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87140","name":"Culture type immunofluoresc","description":"Culture, typing; immunofluorescent method, each antiserum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27894","name":"Decompression of leg","description":"Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s), with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10005","name":"Fna bx w/us gdn 1st les","description":"Fine needle aspiration biopsy, including ultrasound guidance; first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93454","name":"Coronary artery angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84127","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86153","name":"Cell enumeration phys interp","description":"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); physician interpretation and report, when required","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44008.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49501","name":"Rpr ing hernia init blocked","description":"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21557","name":"Resect neck thorax tumor<5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46712","name":"Repr per/vag pouch dbl proc","description":"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; combined transperineal and transabdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581T","name":"Abltj mal brst tum perq crtx","description":"Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3213.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2002","name":"Post-d/c h vst new pt 30 m","description":"Limited (30 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85210","name":"Clot factor ii prothrom spec","description":"Clotting; factor ii, prothrombin, specific","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76882","name":"Us lmtd jt/fcl evl nvasc xtr","description":"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15833","name":"Exc excessive skin leg","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87283","name":"Rubeola ag if","description":"Infectious agent antigen detection by immunofluorescent technique; rubeola","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11602","name":"Exc tr-ext mal+marg 1.1-2 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83045","name":"Hgb methemoglobin qual","description":"Hemoglobin; methemoglobin, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15950","name":"Exc trchntr pr ulc prim sutr","description":"Excision, trochanteric pressure ulcer, with primary suture;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33474","name":"Revision of pulmonary valve","description":"Valvotomy, pulmonary valve, open heart, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1894.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","name":"Anes px art lower leg emblc","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76140","name":"X-ray consultation","description":"Consultation on x-ray examination made elsewhere, written report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27132","name":"Total hip arthroplasty","description":"Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1421.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15157","name":"Tis clt agrft f/s/n/h/f/g ea","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85044","name":"Manual reticulocyte count","description":"Blood count; reticulocyte, manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3060.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37183","name":"Revision tips","description":"Revision of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract recannulization/dilatation, stent placement and all associated imaging guidance and documentation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5002.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69450","name":"Eardrum revision","description":"Tympanolysis, transcanal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31040","name":"Exploration behind upper jaw","description":"Pterygomaxillary fossa surgery, any approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2800.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0518","name":"Remove w insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33367","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92615","name":"Laryngoscopic sensory i&r","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0208T","name":"Audiometry air only","description":"Pure tone audiometry (threshold), automated; air only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25680","name":"Cltx trns-scphprlnr fx mnpj","description":"Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96900","name":"Actinotherapy uv light","description":"Actinotherapy (ultraviolet light)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28175","name":"Resect phalanx of toe tumor","description":"Radical resection of tumor; phalanx of toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85635","name":"Reptilase test","description":"Reptilase test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86615","name":"Bordetella antibody","description":"Antibody; bordetella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58662","name":"Laparoscopy excise lesions","description":"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33542","name":"Removal of heart lesion","description":"Myocardial resection (eg, ventricular aneurysmectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2288.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83525","name":"Assay of insulin","description":"Insulin; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83015","name":"Heavy metal qual any number","description":"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80174","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64837","name":"Repair nerve add-on","description":"Suture of each additional nerve, hand or foot (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67805","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, different lids","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"Nubhvl xm phys/qhp 1st hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97036","name":"App mdlty 1+hubbrd tnk ea 15","description":"Application of a modality to 1 or more areas; hubbard tank, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1734.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33364","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open iliac artery approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72130","name":"Ct chest spine w/o & w/dye","description":"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43268","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"Acoustic immitance testing","description":"Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88262","name":"Chromosome analysis 15-20","description":"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27245","name":"Treat thigh fracture","description":"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1039.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73725","name":"Mr ang lwr ext w or w/o dye","description":"Magnetic resonance angiography, lower extremity, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","name":"Anes 2&3 burn 4-9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; between 4% and 9% of total body surface area","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76536","name":"Us exam of head and neck","description":"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22808","name":"Arthrd ant dfrm 2-3 vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1614.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50220","name":"Remove kidney open","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61650","name":"Evasc prlng admn rx agnt 1st","description":"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial vascular territory","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51845","name":"Repair bladder neck","description":"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, stamey, raz, modified pereyra)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":890.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":996.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2456.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34825","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","name":"Anes thrcm px trach&bronchi","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea and bronchi","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53250","name":"Removal of urethra gland","description":"Excision of bulbourethral gland (cowpers gland)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50695","name":"Plmt ureteral stent prq","description":"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63087","name":"Remov vertbr dcmprn thrclmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2143.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51728","name":"Cystometrogram w/vp","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82107","name":"Alpha-fetoprotein l3","description":"Alpha-fetoprotein (afp); afp-l3 fraction isoform and total afp (including ratio)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77326","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21077","name":"Impres&prep orbital prosth","description":"Impression and custom preparation; orbital prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1469.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26105","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; metacarpophalangeal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15650","name":"Transfer skin pedicle flap","description":"Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, walking tube), any location","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43227","name":"Esophagoscopy control bleed","description":"Esophagoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80186","name":"Assay of phenytoin free","description":"Phenytoin; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87533","name":"Hhv-6 dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27416","name":"Osteochondral knee autograft","description":"Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograft[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76498","name":"Unlisted mr procedure","description":"Unlisted magnetic resonance procedure (eg, diagnostic, interventional)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75954","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58700","name":"Removal of fallopian tube","description":"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87486","name":"Chlmyd pneum dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33220","name":"Repair lead pace-defib dual","description":"Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85245","name":"Clot factor viii vw ristoctn","description":"Clotting; factor viii, vw factor, ristocetin cofactor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"Esrd home pt serv p mo 12-19","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96376","name":"Tx/pro/dx inj same drug adon","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95028","name":"Iq tsts allergy delayed rxn","description":"Intracutaneous (intradermal) tests with allergenic extracts, delayed type reaction, including reading, specify number of tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2881.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84490","name":"Assay of feces for trypsin","description":"Trypsin; feces, quantitative, 24-hour collection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35459","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP12","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63015","name":"Remove spine lamina >2 crvcl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25635","name":"Cltx carpl fx w/mnpj ea b1","description":"Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); with manipulation, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54680","name":"Relocation of testis(es)","description":"Transplantation of testis(es) to thigh (because of scrotal destruction)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59871","name":"Remove cerclage suture","description":"Removal of cerclage suture under anesthesia (other than local)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2753.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78814","name":"Pet image w/ct lmtd","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77021","name":"Mri guidance ndl plmt rs&i","description":"Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84235","name":"Assay of endocrine hormone","description":"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31634","name":"Bronch w/balloon occlusion","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43287","name":"Esphg dstl 2/3 w/laps moblj","description":"Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic e","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3003.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41017","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11646","name":"Exc f/e/e/n/l mal+mrg >4 cm","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65450","name":"Treatment of corneal lesion","description":"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"Pure tone audiometry air","description":"Pure tone audiometry (threshold); air only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29705","name":"Rmvl/bivlv full arm/leg cast","description":"Removal or bivalving; full arm or full leg cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85730","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99484","name":"Care mgmt svc bhvl hlth cond","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of appli","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0394","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60540","name":"Explore adrenal gland","description":"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45300","name":"Proctosigmoidoscopy dx","description":"Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11470","name":"Exc skn h/p/p/u smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with simple or intermediate repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4610.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64605","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43760","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92941","name":"Prq trlml revsc tot occl ami","description":"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single major coronary artery and/or its branches or single bypass g","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51575","name":"Removal of bladder & nodes","description":"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1476.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87301","name":"Adenovirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; adenovirus enteric types 40/41","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11839.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69405","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44211","name":"Lap colectomy w/proctectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (s or j), with loop ileostomy, includes rectal mucosectomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31634","name":"Bronch w/balloon occlusion","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4610.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33859","name":"As-aort grf f/ds oth/thn dsj","description":"Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic disease other than dissection (eg, aneurysm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2126.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21032","name":"Remove exostosis maxilla","description":"Excision of maxillary torus palatinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78494","name":"Heart image spect","description":"Cardiac blood pool imaging, gated equilibrium, spect, at rest, wall motion study plus ejection fraction, with or without quantitative processing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68770","name":"Close tear system fistula","description":"Closure of lacrimal fistula (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43881","name":"Impl/rplcmt gstr nstim eltrd","description":"Implantation or replacement of gastric neurostimulator electrodes, antrum, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58267","name":"Vag hyst w/urinary repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (marshall-marchetti-krantz type, pereyra type) with or without endoscopic control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82024","name":"Assay of acth","description":"Adrenocorticotropic hormone (acth)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38102","name":"Removal of spleen total","description":"Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (list in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0247","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95961","name":"Electrode stimulation brain","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83874","name":"Assay of myoglobin","description":"Myoglobin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93965","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["GT","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94720","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25825","name":"Arthrd wrist with autograft","description":"Arthrodesis, wrist; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65093","name":"Revise eye with implant","description":"Evisceration of ocular contents; with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21256","name":"Reconstruction of orbit","description":"Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15750","name":"Neurovascular pedicle flap","description":"Flap; neurovascular pedicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95710","name":"Eeg w/o vid ea 12-26hr cont","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61519","name":"Remove brain lining lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2719.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0512","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22513","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62303","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0111","name":"Wet mounts/ w preparations","description":"Wet mounts, including preparations of vaginal, cervical or skin specimens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12005","name":"Rpr s/n/a/gen/trk12.6-20.0cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19368","name":"Brst rcnstj 1pdcl tram anast","description":"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (tram) flap, requiring separate microvascular anastomosis (supercharging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1417.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58562","name":"Hysteroscopy remove fb","description":"Hysteroscopy, surgical; with removal of impacted foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65130","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after evisceration, in scleral shell","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4989","name":"Contracept iud","description":"Contraceptive intrauterine device (e.g., progestacert iud), including implants and supplies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26735","name":"Treat finger fracture each","description":"Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation, when performed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0248","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47900","name":"Suture bile duct injury","description":"Suture of extrahepatic biliary duct for pre-existing injury (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1139.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93350","name":"Stress tte only","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35103","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving iliac vessels (common, hypogastric, external)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20605","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93246","name":"Ext ecg>7d<15d recording","description":"External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; recording (includes connection and initial recording)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32940","name":"Revision of lung","description":"Pneumonolysis, extraperiosteal, including filling or packing procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75722","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21060","name":"Remove jaw joint cartilage","description":"Meniscectomy, partial or complete, temporomandibular joint (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86822","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80185","name":"Assay of phenytoin total","description":"Phenytoin; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62355","name":"Remove spinal canal catheter","description":"Removal of previously implanted intrathecal or epidural catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59030","name":"Fetal scalp blood sampling","description":"Fetal scalp blood sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51020","name":"Cystotomy/cystostomy w/fulg","description":"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2339.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31233","name":"Nsl/sins ndsc dx max sinusc","description":"Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy (via inferior meatus or canine fossa puncture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27590","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83903","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80307","name":"Drug test prsmv chem anlyzr","description":"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay [eg, eia, elisa, emit, fpia, ia, kims, ria]), chromatography (eg, gc, hplc), and mass spectrometry either with or without chromatography, (eg, dart","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33229","name":"Remv&replc pm gen mult leads","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; multiple lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50328","name":"Prep renal graft/arterial","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10040","name":"Extraction","description":"Extraction (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64495","name":"Inj paravert f jnt l/s 3 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; third and any additional level(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69620","name":"Myringoplasty","description":"Myringoplasty (surgery confined to drumhead and donor area)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27692","name":"Revise additional leg tendon","description":"Transfer or transplant of single tendon (with muscle redirection or rerouting); each additional tendon (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31400","name":"Revision of larynx","description":"Arytenoidectomy or arytenoidopexy, external approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"Ther/proph/diag inj sc/im","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":167.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0278","name":"Iliac art angio,cardiac cath","description":"Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, inj","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43282","name":"Lap paraesoph her rpr w/mesh","description":"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62311","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61450","name":"Crnec stpl sctj cmprn/dcmprn","description":"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1760.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11606","name":"Exc tr-ext mal+marg >4 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97799","name":"Unlisted physcl med/rehab px","description":"Unlisted physical medicine/rehabilitation service or procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27614","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26350","name":"Repair finger/hand tendon","description":"Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no mans land); primary or secondary without free graft, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25259","name":"Manipulate wrist w/anesthes","description":"Manipulation, wrist, under anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57700","name":"Revision of cervix","description":"Cerclage of uterine cervix, nonobstetrical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92537","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":218.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":6806.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63287","name":"Bx/exc idrl imed lesn thrlmb","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2526.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46754","name":"Removal of suture from anus","description":"Removal of thiersch wire or suture, anal canal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33208","name":"Insrt heart pm atrial & vent","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99328","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97161","name":"Pt eval low complex 20 min","description":"Physical therapy evaluation: low complexity, requiring these components: a history with no personal factors and/or comorbidities that impact the plan of care; an examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67229","name":"Tr retinal les preterm inf","description":"Treatment of extensive or progressive retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1 year of age (eg, retinopathy of prematurity), photocoagulation or cryotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4521","name":"Adult size brief/diaper sm","description":"Adult sized disposable incontinence product, brief/diaper, small, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67911","name":"Revise eyelid defect","description":"Correction of lid retraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92607","name":"Ex for speech device rx 1hr","description":"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2595.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36510","name":"Insertion of catheter vein","description":"Catheterization of umbilical vein for diagnosis or therapy, newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27685","name":"Revision of lower leg tendon","description":"Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0190","name":"Mifepristone, oral, 200 mg","description":"Mifepristone, oral, 200 mg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21742","name":"Repair stern/nuss w/o scope","description":"Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (nuss procedure), without thoracoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58541","name":"Lsh uterus 250 g or less","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20103","name":"Expl pentrg wound extremity","description":"Exploration of penetrating wound (separate procedure); extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25444","name":"Arthrp w/prostc lunate","description":"Arthroplasty with prosthetic replacement; lunate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24579","name":"Optx humrl cndylr fracture","description":"Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2333.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57800","name":"Dilation of cervical canal","description":"Dilation of cervical canal, instrumental (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29899","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64862","name":"Repair of low back nerves","description":"Suture of; lumbar plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1167.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3221","name":"Orthopedic mens shoes dpth i","description":"Orthopedic footwear, mens shoe, depth inlay, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4157","name":"Ef special metabolic inherit","description":"Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0511","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54065","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3219","name":"Orthopedic mens shoes oxford","description":"Orthopedic footwear, mens shoe, oxford, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95857","name":"Cholinesterase challenge","description":"Cholinesterase inhibitor challenge test for myasthenia gravis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87152","name":"Culture type pulse field gel","description":"Culture, typing; identification by pulse field gel typing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84482","name":"T3 reverse","description":"Triiodothyronine t3; reverse","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67975","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4203.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35305","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; tibial or peroneal artery, initial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15120","name":"Splt agrft f/s/n/h/f/g/m 1st","description":"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4722","name":"Dialys sol fld vol > 1999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96130","name":"Psycl tst eval phys/qhp 1st","description":"Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95961","name":"Electrode stimulation brain","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0514","name":"Prolong prev svcs, addl 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86738","name":"Mycoplasma antibody","description":"Antibody; mycoplasma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82928","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82495","name":"Assay of chromium","description":"Chromium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60512","name":"Autotransplant parathyroid","description":"Parathyroid autotransplantation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437T","name":"Impltj synth rnfcmt abdl wal","description":"Implantation of non-biologic or synthetic implant (eg, polypropylene) for fascial reinforcement of the abdominal wall (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33864","name":"Ascending aortic graft","description":"Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with coronary reconstruction and valve-sparing aortic root remodeling (eg, david procedure, yacoub procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2809.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27826","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of fibula only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76102","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","name":"Anes nrv msc upr a&e tndsis","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4874.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93461","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, cath","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1450.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27486","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; 1 component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55530","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0245","name":"Tub stool or bench","description":"Tub stool or bench","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51590","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1569.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23065","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1597.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP16","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42180","name":"Repair lac palate<2 cm","description":"Repair, laceration of palate; up to 2 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":996.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1460.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87808","name":"Trichomonas assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; trichomonas vaginalis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83857","name":"Assay of methemalbumin","description":"Methemalbumin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":5962.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22558","name":"Arthrd ant ntrbd min dsc lum","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1339.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44500","name":"Intro gastrointestinal tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66740","name":"Destruction ciliary body","description":"Ciliary body destruction; cyclodialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28047","name":"Resect foot/toe tumor 3 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32997","name":"Total lung lavage","description":"Total lung lavage (unilateral)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43118","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3028.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1605.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87477","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92943","name":"Prq trluml revsc ch occ ant","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; antegrade","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"Office o/p new sf 15 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceede","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44715","name":"Prepare donor intestine","description":"Backbench standard preparation of cadaver or living donor intestine allograft prior to transplantation, including mobilization and fashioning of the superior mesenteric artery and vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","name":"Anes art sho&ax ax-fem bpg","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64818","name":"Sympathectomy lumbar","description":"Sympathectomy, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1982.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2604.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2187.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C1300","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27215","name":"Treat pelvic fracture(s)","description":"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral, for pelvic bone fracture patterns that do not disrupt the pelvic ring, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43653","name":"Laparoscopy gastrostomy","description":"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7234.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86153","name":"Cell enumeration phys interp","description":"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); physician interpretation and report, when required","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43633","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with roux-en-y reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31360","name":"Removal of larynx","description":"Laryngectomy; total, without radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1556.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87631","name":"Resp virus 3-5 targets","description":"Infectious agent detection by nucleic acid (dna or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87158","name":"Culture typing added method","description":"Culture, typing; other methods","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99359","name":"Prolong serv w/o contact add","description":"Prolonged evaluation and management service before and/or after direct patient care; each additional 30 minutes (list separately in addition to code for prolonged service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561T","name":"Antmc guide 3d print 1st gd","description":"Anatomic guide 3d-printed and designed from image data set(s); first anatomic guide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95981","name":"Io anal gast n-stim subsq","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50860","name":"Transplant ureter to skin","description":"Ureterostomy, transplantation of ureter to skin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4300","name":"Cath impl vasc access portal","description":"Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65756","name":"Corneal trnspl endothelial","description":"Keratoplasty (corneal transplant); endothelial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4538","name":"Diaper serv reusable diaper","description":"Diaper service, reusable diaper, each diaper","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87641","name":"Mr-staph dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); staphylococcus aureus, methicillin resistant, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95851","name":"Range of motion measurements","description":"Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1063.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1751","name":"Cath, inf, per/cent/midline","description":"Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37188","name":"Ven mechnl thrmbc repeat tx","description":"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during course of thrombolytic therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28294","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77770","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36465","name":"Njx noncmpnd sclrsnt 1 vein","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69601","name":"Revj mstdc rsltg compl mstdc","description":"Revision mastoidectomy; resulting in complete mastoidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","name":"Anes thrc spine wo 1lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28635","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15301","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95938","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3332.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93245","name":"Ext ecg>7d<15d rec scan a/r","description":"External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87270","name":"Chlamydia trachomatis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; chlamydia trachomatis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42870","name":"Excision of lingual tonsil","description":"Excision or destruction lingual tonsil, any method (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19290","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47541","name":"Plmt access bil tree sm bwl","description":"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological superv","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86628","name":"Candida antibody","description":"Antibody; candida","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28043","name":"Exc foot/toe tum sc < 1.5 cm","description":"Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3475.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0054T","name":"Bone srgry cmptr fluor image","description":"Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67801","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, same lid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15826","name":"Rhytidectomy glblr frn lines","description":"Rhytidectomy; glabellar frown lines","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87551","name":"Mycobacteria dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36838","name":"Dist revas ligation hemo","description":"Distal revascularization and interval ligation (dril), upper extremity hemodialysis access (steal syndrome)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":226.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23066","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; deep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"Psytx w pt w e/m 30 min","description":"Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33514","name":"Cabg vein five","description":"Coronary artery bypass, vein only; 5 coronary venous grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2274.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93040","name":"Rhythm ecg with report","description":"Rhythm ecg, 1-3 leads; with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27407","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; cruciate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29510.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21179","name":"Rcnstj forehead with grafts","description":"Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1281.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28575","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35526","name":"Art byp grft aor/carot/innom","description":"Bypass graft, with vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1504.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93965","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93924","name":"Lwr xtr vasc stdy bilat","description":"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a st","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6019","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88112","name":"Cytopath cell enhance tech","description":"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64613","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27596","name":"Amputation follow-up surgery","description":"Amputation, thigh, through femur, any level; re-amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44005","name":"Freeing of bowel adhesion","description":"Enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6011","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55150","name":"Removal of scrotum","description":"Resection of scrotum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4470.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73220","name":"Mri uppr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1662.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21034","name":"Excise max/zygoma mal tumor","description":"Excision of malignant tumor of maxilla or zygoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2756.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","name":"Anes vag px crv cerclage","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19271","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24361","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with distal humeral prosthetic replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77416","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82383","name":"Assay blood catecholamines","description":"Catecholamines; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47540","name":"Perq plmt bile duct stent","description":"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; new access,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3710.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93533","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2112.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","name":"Anes px art knee&pop exc&grf","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11828.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11057","name":"Parng/cutg b9 hyprkr les >4","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than 4 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93581","name":"Transcath closure of vsd","description":"Percutaneous transcatheter closure of a congenital ventricular septal defect with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1422.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47760","name":"Fuse bile ducts and bowel","description":"Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1883.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25111","name":"Remove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); primary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99468","name":"Neonate crit care initial","description":"Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3290.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11640","name":"Exc f/e/e/n/l mal+mrg 0.5cm<","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5072.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7236.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31830","name":"Revise windpipe scar","description":"Revision of tracheostomy scar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57282","name":"Colpopexy extraperitoneal","description":"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11443","name":"Exc face-mm b9+marg 2.1-3 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27156","name":"Revision of hip bones","description":"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy and with open reduction of hip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27784","name":"Treatment of fibula fracture","description":"Open treatment of proximal fibula or shaft fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28100","name":"Removal of ankle/heel lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52334","name":"Create passage to kidney","description":"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21210","name":"Face bone graft","description":"Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1591.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28636","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95805","name":"Multiple sleep latency test","description":"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3010.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78709","name":"K flow/funct image multiple","description":"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0270","name":"Mnt subs tx for change dx","description":"Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84577","name":"Assay of feces/urobilinogen","description":"Urobilinogen, feces, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81439","name":"Hrdtry cardmypy gene panel","description":"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at least 5 cardiomyopathy-related genes (eg, dsg2, mybpc3, myh7, pkp2, ttn)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35484","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28800","name":"Amputation of midfoot","description":"Amputation, foot; midtarsal (eg, chopart type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86747","name":"Parvovirus antibody","description":"Antibody; parvovirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29505","name":"Application long leg splint","description":"Application of long leg splint (thigh to ankle or toes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85530","name":"Heparin-protamine tolerance","description":"Heparin-protamine tolerance test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87109","name":"Mycoplasma","description":"Culture, mycoplasma, any source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22830","name":"Exploration of spinal fusion","description":"Exploration of spinal fusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15769","name":"Grfg autol soft tiss dir exc","description":"Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86674","name":"Giardia lamblia antibody","description":"Antibody; giardia lamblia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27687","name":"Revision of calf tendon","description":"Gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50705","name":"Ureteral embolization/occl","description":"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22523","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94619","name":"Exercise tst brncspsm wo ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; without electrocardiographic recording(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2305.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33660","name":"Repair of heart defects","description":"Repair of incomplete or partial atrioventricular canal (ostium primum atrial septal defect), with or without atrioventricular valve repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1528.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81596","name":"Nfct ds chrnc hcv 6 assays","description":"Infectious disease, chronic hepatitis c virus (hcv) infection, six biochemical assays (alt, a2-macroglobulin, apolipoprotein a-1, total bilirubin, ggt, and haptoglobin) utilizing serum, prognostic algorithm reported as scores for fibrosis and necroinflammatory activity in liver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8053.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21335","name":"Open tx nose & septal fx","description":"Open treatment of nasal fracture; with concomitant open treatment of fractured septum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40702","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58740","name":"Adhesiolysis tube ovary","description":"Lysis of adhesions (salpingolysis, ovariolysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1390.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36620","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22900","name":"Exc abdl tum deep < 5 cm","description":"Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21552","name":"Exc neck les sc 3 cm/>","description":"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25259","name":"Manipulate wrist w/anesthes","description":"Manipulation, wrist, under anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87799","name":"Detect agent nos dna quant","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; quantification, each organism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4554.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","name":"Anes upr gi ndsc px ercp","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ercp)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27096","name":"Inject sacroiliac joint","description":"Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or ct) including arthrography when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75960","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6784.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83916","name":"Oligoclonal bands","description":"Oligoclonal immune (oligoclonal bands)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14060","name":"Tis trnfr e/n/e/l 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91065","name":"Breath hydrogen/methane test","description":"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31002","name":"Irrigation sphenoid sinus","description":"Lavage by cannulation; sphenoid sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95170","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; whole body extract of biting insect or other arthropod (specify number of doses)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68850","name":"Injection for tear sac x-ray","description":"Injection of contrast medium for dacryocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99363","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93621","name":"Comp ep evl l pac&rec c sins","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29805","name":"Sho arthrs dx +- synovial bx","description":"Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88283","name":"Chromosome banding study","description":"Chromosome analysis; additional specialized banding technique (eg, nor, c-banding)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49429","name":"Removal of shunt","description":"Removal of peritoneal-venous shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42500","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; primary or simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93455","name":"Coronary art/grft angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31020","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); intranasal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27487","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1492.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55250","name":"Removal of sperm duct(s)","description":"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25071","name":"Exc forearm les sc 3 cm/>","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","name":"Anes integumentary sys nos","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33471","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1148.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74178","name":"Ct abd&plv wo cntr flwd cntr","description":"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77051","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43263","name":"Ercp sphincter pressure meas","description":"Endoscopic retrograde cholangiopancreatography (ercp); with pressure measurement of sphincter of oddi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26553","name":"Single transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2772.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27350","name":"Removal of kneecap","description":"Patellectomy or hemipatellectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86622","name":"Brucella antibody","description":"Antibody; brucella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1590.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41830","name":"Removal of gum tissue","description":"Alveolectomy, including curettage of osteitis or sequestrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93745","name":"Set-up cardiovert-defibrill","description":"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ecg, transmission of data to data repository, patient instruction in wearing system and patient re","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50860","name":"Transplant ureter to skin","description":"Ureterostomy, transplantation of ureter to skin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37181","name":"Splice spleen/kidney veins","description":"Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2045.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88350","name":"Imfluor ea addl 1antb stn px","description":"Immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26540","name":"Repair hand joint","description":"Repair of collateral ligament, metacarpophalangeal or interphalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":277.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21337","name":"Closed tx septal&nose fx","description":"Closed treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78272","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73721","name":"Mri jnt of lwr extre w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01232","name":"Anes opn px upr 2/3 fem amp","description":"Anesthesia for open procedures involving upper two-thirds of femur; amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96167","name":"Hlth bhv ivntj fam 1st 30","description":"Health behavior intervention, family (with the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54560","name":"Exploration for testis","description":"Exploration for undescended testis with abdominal exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92652","name":"Aep thrshld est mlt freq i&r","description":"Auditory evoked potentials; for threshold estimation at multiple frequencies, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85220","name":"Blooc clot factor v test","description":"Clotting; factor v (acg or proaccelerin), labile factor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21810","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17340","name":"Cryotherapy for acne","description":"Cryotherapy (co2 slush, liquid n2) for acne","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21440","name":"Cltx mndblr/max alv ridge fx","description":"Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4989","name":"Contracept iud","description":"Contraceptive intrauterine device (e.g., progestacert iud), including implants and supplies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12035","name":"Intmd rpr s/a/t/ext 12.6-20","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46200","name":"Removal of anal fissure","description":"Fissurectomy, including sphincterotomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55831","name":"Removal of prostate","description":"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61458","name":"Crnec sopl xpl/dcmpr crl nrv","description":"Craniectomy, suboccipital; for exploration or decompression of cranial nerves","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1839.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26372","name":"Repair/graft hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; secondary with free graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1115.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1742.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KM","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1009.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78588","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86334","name":"Immunofix e-phoresis serum","description":"Immunofixation electrophoresis; serum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2065","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87592","name":"N.gonorrhoeae dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0016","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26455","name":"Incision of finger tendon","description":"Tenotomy, flexor, finger, open, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21295","name":"Revision of jaw muscle/bone","description":"Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); extraoral approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49654","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27134","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; both components, with or without autograft or allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1625.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64410","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26665","name":"Treat thumb fracture","description":"Open treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97537","name":"Community/work reintegration","description":"Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or work environment/modification analysis, work task analysis, use of assistive technology device/adaptive equipment), direct one-on-one contact, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29914","name":"Hip arthro w/femoroplasty","description":"Arthroscopy, hip, surgical; with femoroplasty (ie, treatment of cam lesion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85557","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; incubated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93454","name":"Coronary artery angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99469","name":"Neonate crit care subsq","description":"Subsequent inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83090","name":"Assay of homocysteine","description":"Homocysteine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32556","name":"Insert cath pleura w/o image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64630","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; pudendal nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6404","name":"Sterile gauze > 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32658","name":"Thoracoscopy w/sac fb remove","description":"Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84238","name":"Assay nonendocrine receptor","description":"Receptor assay; non-endocrine (specify receptor)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88318","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76880","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93786","name":"Ambl bp mntr w/sw rec only","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; recording only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87903","name":"Phenotype dna hiv w/culture","description":"Infectious agent phenotype analysis by nucleic acid (dna or rna) with drug resistance tissue culture analysis, hiv 1; first through 10 drugs tested","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65286","name":"Repair of eye wound","description":"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23930","name":"I&d upr a/e dp absc/hmtma","description":"Incision and drainage, upper arm or elbow area; deep abscess or hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90632","name":"Hepa vaccine adult im","description":"Hepatitis a vaccine (hepa), adult dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61539","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2168.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83586","name":"Assay 17- ketosteroids","description":"Ketosteroids, 17- (17-ks); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42510","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with ligation of both submandibular (whartons) ducts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50386","name":"Remove stent via transureth","description":"Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44705","name":"Prepare fecal microbiota","description":"Preparation of fecal microbiota for instillation, including assessment of donor specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61531","name":"Implant brain electrodes","description":"Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L6639","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80162","name":"Assay of digoxin total","description":"Digoxin; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7274","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15920","name":"Exc coccygl pr ulc prim sutr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with primary suture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0247","name":"Routine footcare pt w lops","description":"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wou","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97113","name":"Aquatic therapy/exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25931","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; re-amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98927","name":"Osteopath manj 5-6 regions","description":"Osteopathic manipulative treatment (omt); 5-6 body regions involved","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3208.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93567","name":"Njx car cth sprvlv aortgrphy","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61536","name":"Removal of brain lesion","description":"Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83858","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22103","name":"Remove extra spine segment","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1354.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84228","name":"Assay of quinine","description":"Quinine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78494","name":"Heart image spect","description":"Cardiac blood pool imaging, gated equilibrium, spect, at rest, wall motion study plus ejection fraction, with or without quantitative processing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49402","name":"Remove foreign body adbomen","description":"Removal of peritoneal foreign body from peritoneal cavity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74262","name":"Ct colonography dx w/dye","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11043","name":"Dbrdmt musc&/fsca 1st 20/<","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99315","name":"Nf dschrg mgmt 30 min/less","description":"Nursing facility discharge management; 30 minutes or less total time on the date of the encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32440","name":"Remove lung pneumonectomy","description":"Removal of lung, pneumonectomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36011","name":"Place catheter in vein","description":"Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40814","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25805","name":"Arthrd wrist w/sliding graft","description":"Arthrodesis, wrist; with sliding graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19369","name":"Brst rcnstj 2 pdcl tram flap","description":"Breast reconstruction; with bipedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1317.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93985","name":"Dup-scan hemo compl bi std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0201T","name":"Perq sacral augmt bilat inj","description":"Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, 2 or more needles, includes imaging guidance and bone biopsy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20932","name":"Osteoart algrft w/surf & b1","description":"Allograft, includes templating, cutting, placement and internal fixation, when performed; osteoarticular, including articular surface and contiguous bone (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3794.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27397","name":"Transplants of thigh tendons","description":"Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); multiple tendons","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82670","name":"Assay of total estradiol","description":"Estradiol; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91035","name":"G-esoph reflx tst w/electrod","description":"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry ph electrode placement, recording, analysis and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84512","name":"Assay of troponin qual","description":"Troponin, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77058","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31500","name":"Insert emergency airway","description":"Intubation, endotracheal, emergency procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93355","name":"Echo transesophageal (tee)","description":"Echocardiography, transesophageal (tee) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, tavr, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial appendage occlusion/closure, ventricular septal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83634","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33776","name":"Rpr tga atr bfl clsr vsd","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with closure of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1701.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94070","name":"Evaluation of wheezing","description":"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11920","name":"Correct skin color 6.0 cm/<","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.0 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5364","name":"Dysphagia screening","description":"Dysphagia screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77768","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68520","name":"Removal of tear sac","description":"Excision of lacrimal sac (dacryocystectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28080","name":"Removal of foot lesion","description":"Excision, interdigital (morton) neuroma, single, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27445","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24675","name":"Cltx ulnar fx prox w/mnpj","description":"Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","name":"Anes opn/arthr px sho jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40842","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27326","name":"Neurectomy popliteal","description":"Neurectomy, popliteal (gastrocnemius)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4537","name":"Reusable underpad bed size","description":"Incontinence product, protective underpad, reusable, bed size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54150","name":"Circumcision w/regionl block","description":"Circumcision, using clamp or other device with regional dorsal penile or ring block","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27275","name":"Manipulation of hip joint","description":"Manipulation, hip joint, requiring general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27245","name":"Treat thigh fracture","description":"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1039.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64475","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38207","name":"Cryopreserve stem cells","description":"Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2062","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88375","name":"Optical endomicroscpy interp","description":"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84588","name":"Assay of vasopressin","description":"Vasopressin (antidiuretic hormone, adh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29200","name":"Strapping thorax","description":"Strapping; thorax","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2158.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33240","name":"Insrt pulse gen w/singl lead","description":"Insertion of implantable defibrillator pulse generator only; with existing single lead","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95936","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","name":"Anes arthr/ndsc wrst/hnd nos","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31081","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50610","name":"Removal of ureter stone","description":"Ureterolithotomy; upper one-third of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84510","name":"Assay of tyrosine","description":"Tyrosine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93529","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13120","name":"Cmplx rpr s/a/l 1.1-2.5 cm","description":"Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64630","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; pudendal nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99449","name":"Ntrprof ph1/ntrnet/ehr 31/>","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99460","name":"Init nb em per day hosp","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26842","name":"Thumb fusion with graft","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":49.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1027.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64560","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59412","name":"Antepartum manipulation","description":"External cephalic version, with or without tocolysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29885","name":"Arthrs kne srg drlg ost diss","description":"Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29823","name":"Sho arthrs srg xtnsv dbrdmt","description":"Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the ro","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31591","name":"Laryngoplasty medialization","description":"Laryngoplasty, medialization, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90802","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51860","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":142.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0010","name":"Admin hepatitis b vaccine","description":"Administration of hepatitis b vaccine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92225","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96402","name":"Chemo hormon antineopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27640","name":"Partial removal of tibia","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86357","name":"Nk cells total count","description":"Natural killer (nk) cells, total count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87531","name":"Hhv-6 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP12","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27457","name":"Realignment of knee","description":"Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); after epiphyseal closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","name":"Anes open px lower l/a/f nos","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15175","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40700","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63090","name":"Remove vert body dcmprn lmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1712.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74245","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28456","name":"Prq skel fix tarsl fx w/mnpj","description":"Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with manipulation, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4232","name":"Syringe w/needle insulin 3cc","description":"Syringe with needle for external insulin pump, sterile, 3 cc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34451","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by abdominal and leg incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32994","name":"Ablate pulm tumor perq crybl","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4082.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33415","name":"Revision subvalvular tissue","description":"Resection or incision of subvalvular tissue for discrete subvalvular aortic stenosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1758.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","name":"Anes px nrv msc upr a&e tnot","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42835","name":"Removal of adenoids","description":"Adenoidectomy, secondary; younger than age 12","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88372","name":"Protein analysis w/probe","description":"Protein analysis of tissue by western blot, with interpretation and report; immunological probe for band identification, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69717","name":"Rplcmt oi implt skl prq esp","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2479.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF"]},{"negotiated_type":"negotiated","negotiated_rate":6118.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61215","name":"Ins subq rsvr pmp/nfs sys","description":"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23140","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33226","name":"Reposition l ventric lead","description":"Repositioning of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion and/or replacement of existing generator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88331","name":"Path consltj surg 1 blk 1spc","description":"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96131","name":"Psycl tst eval phys/qhp ea","description":"Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65205","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93248","name":"Ext ecg>7d<15d rev&interpj","description":"External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; review and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42280","name":"Preparation palate mold","description":"Maxillary impression for palatal prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","name":"Anes art sho&ax ax-brch arsm","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37214","name":"Cessj therapy cath removal","description":"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8936.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84120","name":"Assay of urine porphyrins","description":"Porphyrins, urine; quantitation and fractionation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93320","name":"Doppler echo complete","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479T","name":"Fxjl abl lsr 1st 100 sq cm","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof, or 1% of body surface area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33440","name":"Rplcmt a-valve tlcj autol pv","description":"Replacement, aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved conduit replacement of pulmonary valve (ross-konno procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15430","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95870","name":"Ndl emg lmtd std musc 1 xtr","description":"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93040","name":"Rhythm ecg with report","description":"Rhythm ecg, 1-3 leads; with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24160","name":"Rmvl prosthhumrl&ulnar cmpnt","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and ulnar components","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99377","name":"Hospice care supervision","description":"Supervision of a hospice patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77048","name":"Mri breast c-+ w/cad uni","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01931","name":"Anes ivnt rad ntrhpt/prt crc","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrahepatic or portal circulation (eg, transvenous intrahepatic portosystemic shunt[s] [tips])","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43276","name":"Ercp stent exchange w/dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent exchanged","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57460","name":"Bx of cervix w/scope leep","description":"Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74221","name":"X-ray xm esophagus 2cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9482","name":"Remote e/m new pt 20mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decisi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77078","name":"Ct bone density axial","description":"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52282","name":"Cystoscopy implant stent","description":"Cystourethroscopy, with insertion of permanent urethral stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","name":"Anes opn/arthr elb tot rplct","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33420","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; closed heart","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9645.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50398","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17360","name":"Chemical exfoliation acne","description":"Chemical exfoliation for acne (eg, acne paste, acid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67332","name":"Rerevise eye muscles add-on","description":"Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49568","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27443","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42340","name":"Removal of salivary stone","description":"Sialolithotomy; parotid, extraoral or complicated intraoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47490","name":"Incision of gallbladder","description":"Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when performed, and radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27284","name":"Arthrodesis hip joint","description":"Arthrodesis, hip joint (including obtaining graft);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2803.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3405.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77432","name":"Stereotactic radiation trmt","description":"Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33692","name":"Comp rpr tof wo pulm atresia","description":"Complete repair tetralogy of fallot without pulmonary atresia;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95076","name":"Ingest challenge ini 120 min","description":"Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance); initial 120 minutes of testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6932.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59051","name":"Fetal monitor/interpret only","description":"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84110","name":"Assay of porphobilinogen","description":"Porphobilinogen, urine; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93501","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46257","name":"Remove in/ex hem grp & fiss","description":"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0042T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25250","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35685","name":"Bypass graft patency/patch","description":"Placement of vein patch or cuff at distal anastomosis of bypass graft, synthetic conduit (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43520","name":"Incision of pyloric muscle","description":"Pyloromyotomy, cutting of pyloric muscle (fredet-ramstedt type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21497","name":"Interdental wirg oth/thn fx","description":"Interdental wiring, for condition other than fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80172","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43113","name":"Removal of esophagus","description":"Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3638.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":110.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43100","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; cervical approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26510","name":"Thumb tendon transfer","description":"Cross intrinsic transfer, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3043.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6198","name":"Alginate dressing > 48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11201","name":"Rmvl skin tags ea addl 10","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33917","name":"Repair pulmonary artery","description":"Repair of pulmonary artery stenosis by reconstruction with patch or graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96001","name":"Motion test w/ft press meas","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics; with dynamic plantar pressure measurements during walking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52318","name":"Remove bladder stone","description":"Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91307","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8645.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92341","name":"Fit spectacles bifocal","description":"Fitting of spectacles, except for aphakia; bifocal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3060.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74210","name":"X-ray xm phrnx&/crv esoph c+","description":"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86677","name":"Helicobacter pylori antibody","description":"Antibody; helicobacter pylori","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77338","name":"Design mlc device for imrt","description":"Multi-leaf collimator (mlc) device(s) for intensity modulated radiation therapy (imrt), design and construction per imrt plan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22614","name":"Arthrd pst tq 1ntrspc ea add","description":"Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86162","name":"Complement total (ch50)","description":"Complement; total hemolytic (ch50)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43288","name":"Esphg thrsc moblj","description":"Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, th","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3136.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"Init pm e/m new pat 1-4 yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41250","name":"Repair tongue laceration","description":"Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86830","name":"Hla class i phenotype qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); antibody identification by qualitative panel using complete hla phenotypes, hla class i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74248","name":"X-ray sm int f-thru std","description":"Radiologic small intestine follow-through study, including multiple serial images (list separately in addition to code for primary procedure for upper gi radiologic examination)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"Office o/p est sf 10 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27193","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67710","name":"Severing tarsorrhaphy","description":"Severing of tarsorrhaphy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73550","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26567","name":"Correct finger deformity","description":"Osteotomy; phalanx of finger, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58543","name":"Lsh uterus above 250 g","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25680","name":"Cltx trns-scphprlnr fx mnpj","description":"Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27075","name":"Resect hip tumor","description":"Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis pubis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1778.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55865","name":"Extensive prostate surgery","description":"Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2058","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93295","name":"Dev interrog remote 1/2/mlt","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21047","name":"Excise lwr jaw cyst w/repair","description":"Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11105","name":"Punch bx skin ea sep/addl","description":"Punch biopsy of skin (including simple closure, when performed); each separate/additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26358","name":"Repair/graft hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); secondary, with free graft (includes obtaining graft), each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16025","name":"Dress/debrid p-thick burn m","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27198","name":"Clsd tx pelvic ring fx","description":"Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; with ma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77770","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92558","name":"Evoked auditory test qual","description":"Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","name":"Anes px arteries upr leg nos","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4247","name":"Betadine/iodine swabs/wipes","description":"Betadine or iodine swabs/wipes, per box","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9262.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25425","name":"Repair/graft radius or ulna","description":"Repair of defect with autograft; radius or ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50970","name":"Ureter endoscopy","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1097.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4606.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0121","name":"Colon ca scrn not hi rsk ind","description":"Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","53"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43340","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82384","name":"Assay three catecholamines","description":"Catecholamines; fractionated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59140","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; cervical, with evacuation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35693","name":"Art trnsposj subclavian","description":"Transposition and/or reimplantation; vertebral to subclavian artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67908","name":"Repair eyelid defect","description":"Repair of blepharoptosis; conjunctivo-tarso-mullers muscle-levator resection (eg, fasanella-servat type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23075","name":"Exc shoulder les sc < 3 cm","description":"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49320","name":"Diag laparo separate proc","description":"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92611","name":"Motion fluoroscopy/swallow","description":"Motion fluoroscopic evaluation of swallowing function by cine or video recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83520","name":"Immunoassay quant nos nonab","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95132","name":"Immntx 3 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 3 stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64488","name":"Tap block bi injection","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85441","name":"Heinz bodies direct","description":"Heinz bodies; direct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34716","name":"Opn ax/subcla art expos cndt","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97165","name":"Ot eval low complex 30 min","description":"Occupational therapy evaluation, low complexity, requiring these components: an occupational profile and medical and therapy history, which includes a brief history including review of medical and/or therapy records relating to the presenting problem; an assessment(s) that identifies 1-3 performance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92582","name":"Conditioning play audiometry","description":"Conditioning play audiometry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9278","name":"External receiver, cgm sys","description":"Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1754.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54001","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27301","name":"Drain thigh/knee lesion","description":"Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444T","name":"1st plmt drug elut oc ins","description":"Initial placement of a drug-eluting ocular insert under one or more eyelids, including fitting, training, and insertion, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74245","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38220","name":"Dx bone marrow aspirations","description":"Diagnostic bone marrow; aspiration(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31235","name":"Nsl/sins ndsc dx sphn sinusc","description":"Nasal/sinus endoscopy, diagnostic; with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91301","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37600","name":"Ligation xtrnl carotid art","description":"Ligation; external carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90715","name":"Tdap vaccine 7 yrs/> im","description":"Tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap), when administered to individuals 7 years or older, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25915","name":"Amputation of forearm","description":"Krukenberg procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52342","name":"Cysto w/up stricture tx","description":"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61606","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2620.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35585","name":"Vein byp fem-tibial peroneal","description":"In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1478.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38792","name":"Ra tracer id of sentinl node","description":"Injection procedure; radioactive tracer for identification of sentinel node","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85598","name":"Hexagnal phosph pltlt neutrl","description":"Phospholipid neutralization; hexagonal phospholipid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27590","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11011","name":"Debride skin musc at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, and muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44363","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83615","name":"Lactate (ld) (ldh) enzyme","description":"Lactate dehydrogenase (ld), (ldh);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78804","name":"Rp loclzj tum whbdy 2+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33977","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60100","name":"Biopsy of thyroid","description":"Biopsy thyroid, percutaneous core needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"Home/res vst new sf mdm 15","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","name":"Anes clsd ch mediast&thrc w/","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44136","name":"Intestine transplant live","description":"Intestinal allotransplantation; from living donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93268","name":"Ecg record/review","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; includes transmission, review and interpretation by a physician or other qualified hea","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69910","name":"Remove inner ear & mastoid","description":"Labyrinthectomy; with mastoidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85345","name":"Coagulation time lee & white","description":"Coagulation time; lee and white","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72270","name":"Myelogphy 2/> spine regions","description":"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32800","name":"Repair lung hernia","description":"Repair lung hernia through chest wall","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65103","name":"Remove eye/insert implant","description":"Enucleation of eye; with implant, muscles not attached to implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0445","name":"High inten beh couns std 30m","description":"High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77525","name":"Proton treatment complex","description":"Proton treatment delivery; complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","name":"Anes trurl px urtrl cal rmvl","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1389.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4098","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00528","name":"Anes clsd ch mediast&thrc wo","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80076","name":"Hepatic function panel","description":"Hepatic function panel this panel must include the following: albumin (82040) bilirubin, total (82247) bilirubin, direct (82248) phosphatase, alkaline (84075) protein, total (84155) transferase, alanine amino (alt) (sgpt) (84460) transferase, aspartate amino (ast) (sgot) (84450)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46710","name":"Repr per/vag pouch sngl proc","description":"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; transperineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":925.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64835","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; median motor thenar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0328","name":"Ped hospital bed, manual","description":"Hospital bed, pediatric, manual, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92538","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87205","name":"Smear gram stain","description":"Smear, primary source with interpretation; gram or giemsa stain for bacteria, fungi, or cell types","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27442","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86146","name":"Beta-2 glycoprotein antibody","description":"Beta 2 glycoprotein i antibody, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77372","name":"Srs linear based","description":"Radiation treatment delivery, stereotactic radiosurgery (srs), complete course of treatment of cranial lesion(s) consisting of 1 session; linear accelerator based","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61581","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2177.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86332","name":"Immune complex assay","description":"Immune complex assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50900","name":"Repair of ureter","description":"Ureterorrhaphy, suture of ureter (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1002.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0329","name":"Electromagntic tx for ulcers","description":"Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93653","name":"Compre ep eval tx svt","description":"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording and catheter ablation of arrhythmogenic focus, including intracardiac electrophysiologic 3-dimensiona","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78483","name":"Heart first pass multiple","description":"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83896","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95979","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67107","name":"Repair detached retina","description":"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31552","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, age 12 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93620","name":"Comp ep evl r at ven pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563T","name":"Evac meibomian glnd heat bi","description":"Evacuation of meibomian glands, using heat delivered through wearable, open-eye eyelid treatment devices and manual gland expression, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5635.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42825","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; younger than age 12","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53860","name":"Transurethral rf treatment","description":"Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96371","name":"Sc ther infusion reset pump","description":"Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); additional pump set-up with establishment of new subcutaneous infusion site(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41252","name":"Repair tongue laceration","description":"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11402","name":"Exc tr-ext b9+marg 1.1-2 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15340","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":33.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23105","name":"Arthrotomy glenohumeral jt","description":"Arthrotomy; glenohumeral joint, with synovectomy, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4152","name":"Ef calorie dense>/=1.5kcal","description":"Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55705","name":"Bx prst8 any approach nonimg","description":"Biopsy, prostate, any approach, nonimaging-guided","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43632","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastrojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29824","name":"Sho arthrs srg dstl claviclc","description":"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (mumford procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43258","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83912","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4023.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33944","name":"Prepare donor heart","description":"Backbench standard preparation of cadaver donor heart allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, pulmonary artery, and left atrium for implantation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40804","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93875","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"S3835","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":20.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70557","name":"Mri brain w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96105","name":"Assessment of aphasia","description":"Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by boston diagnostic aphasia examination) with interpretation and report, per hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90819","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37145","name":"Revision of circulation","description":"Venous anastomosis, open; renoportal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1895.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46200","name":"Removal of anal fissure","description":"Fissurectomy, including sphincterotomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74241","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01953","name":"Anes 2&3 burn ea add 9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; each additional 9% total body surface area or part thereof (list separately in addition to code for primary procedur","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2474.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61592","name":"Orbitocranial approach/skull","description":"Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural elevation of temporal lobe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2863.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51597","name":"Removal of pelvic structures","description":"Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1863.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21188","name":"Reconstruction of midface","description":"Reconstruction midface, osteotomies (other than lefort type) and bone grafts (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1294.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83663","name":"Fluoro polarize fetal lung","description":"Fetal lung maturity assessment; fluorescence polarization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34111","name":"Removal of arm artery clot","description":"Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, by arm incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27692","name":"Revise additional leg tendon","description":"Transfer or transplant of single tendon (with muscle redirection or rerouting); each additional tendon (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64890","name":"Nrv grf 1strnd hnd/foot <4cm","description":"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61154","name":"Burr hole w/evac&/drg hmtma","description":"Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0283","name":"Elec stim other than wound","description":"Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46922","name":"Excision of anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57268","name":"Repair of bowel bulge","description":"Repair of enterocele, vaginal approach (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27003","name":"Tnot adductr subq opn neurct","description":"Tenotomy, adductor, subcutaneous, open, with obturator neurectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86235","name":"Nuclear antigen antibody","description":"Extractable nuclear antigen, antibody to, any method (eg, nrnp, ss-a, ss-b, sm, rnp, sc170, j01), each antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44366","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2551.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95887","name":"Musc tst done w/n tst nonext","description":"Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25020","name":"Decompress forearm 1 space","description":"Decompression fasciotomy, forearm and/or wrist, flexor or extensor compartment; without debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19260","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26860","name":"Fusion of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26676","name":"Pin hand dislocation","description":"Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, with manipulation, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","name":"Anes male gent rad orch ing","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35400","name":"Angioscopy","description":"Angioscopy (noncoronary vessels or grafts) during therapeutic intervention (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4725.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17262","name":"Dstrj mal les t/a/l 1.1-2.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94669","name":"Mechanical chest wall oscill","description":"Mechanical chest wall oscillation to facilitate lung function, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9262.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33979","name":"Insert intracorporeal device","description":"Insertion of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1700.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87542","name":"Legion pneumo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49014","name":"Reexploration pelvic wound","description":"Re-exploration of pelvic wound with removal of preperitoneal pelvic packing, including repacking, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27405","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; collateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2055.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29355","name":"Appl long leg cast walker","description":"Application of long leg cast (thigh to toes); walker or ambulatory type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22868","name":"Insj stablj dev w/dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32420","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96415","name":"Chemo iv infusion addl hr","description":"Chemotherapy administration, intravenous infusion technique; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72158","name":"Mri lumbar spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61645","name":"Perq art m-thrombect &/nfs","description":"Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and intraprocedural pharmacological thrombolytic injection(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83873","name":"Assay of csf protein","description":"Myelin basic protein, cerebrospinal fluid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21184","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 80 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2098.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95056","name":"Photo tests","description":"Photo tests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27339","name":"Exc thigh/knee tum dep 5cm/>","description":"Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46080","name":"Sphnctrotmy anal div sphnctr","description":"Sphincterotomy, anal, division of sphincter (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":762.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52325","name":"Cystoscopy stone removal","description":"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64713","name":"Revision of arm nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","name":"Anes thrcm px trach&bronchi","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea and bronchi","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40490","name":"Biopsy of lip","description":"Biopsy of lip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65235","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from anterior chamber of eye or lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35492","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4860","name":"Disposable catheter tips","description":"Disposable catheter tips for peritoneal dialysis, per 10","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41110","name":"Excision of tongue lesion","description":"Excision of lesion of tongue without closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93458","name":"L hrt artery/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63012","name":"Remove lamina/facets lumbar","description":"Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (gill type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75791","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1862.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48540","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; roux-en-y","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33403","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33966","name":"Ecmo/ecls rmvl prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33961","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86162","name":"Complement total (ch50)","description":"Complement; total hemolytic (ch50)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","name":"Anes integ sys rad brst dsj","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61585","name":"Orbitocranial approach/skull","description":"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2962.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54400","name":"Insert semi-rigid prosthesis","description":"Insertion of penile prosthesis; non-inflatable (semi-rigid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67335","name":"Eye suture during surgery","description":"Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (list separately in addition to code for specific strabismus surgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0075T","name":"Perq stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36600","name":"Withdrawal of arterial blood","description":"Arterial puncture, withdrawal of blood for diagnosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95939","name":"C motor evoked upr&lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27742","name":"Repair of leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula; and distal femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27626","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle; including tenosynovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37195","name":"Thrombolytic therapy stroke","description":"Thrombolysis, cerebral, by intravenous infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27502","name":"Treatment of thigh fracture","description":"Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39501","name":"Repair diaphragm laceration","description":"Repair, laceration of diaphragm, any approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74262","name":"Ct colonography dx w/dye","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84285","name":"Assay of silica","description":"Silica","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84585","name":"Assay of urine vma","description":"Vanillylmandelic acid (vma), urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9262.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0414","name":"Pelvic ring fx treat int fix","description":"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17003","name":"Destruct premalg les 2-14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62140","name":"Crnop skull defect<5 cm diam","description":"Cranioplasty for skull defect; up to 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41115","name":"Excision of tongue fold","description":"Excision of lingual frenum (frenectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505T","name":"Ev fempop artl revsc","description":"Endovenous femoral-popliteal arterial revascularization, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultrasound guidance for vascular access when performed, all catheterization(s) and intraprocedural roadmapp","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43501","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of bleeding ulcer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1125.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36218","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family (list in addition to code for initial second or third order vessel as appropriate)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61150","name":"Bur hol/trph drg brn abs/cst","description":"Burr hole(s) or trephine; with drainage of brain abscess or cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1233.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95012","name":"Nitric oxide exp gas deter","description":"Nitric oxide expired gas determination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95961","name":"Electrode stimulation brain","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33954","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, 6 years and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83891","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57260","name":"Cmbn ant pst colprhy","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35521","name":"Art byp grft axill-femoral","description":"Bypass graft, with vein; axillary-femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1082.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2012","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27618","name":"Exc leg/ankle tum < 3 cm","description":"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96167","name":"Hlth bhv ivntj fam 1st 30","description":"Health behavior intervention, family (with the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","name":"Anes iper upr abd gstr px mo","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74183","name":"Mri abd w/o cntr flwd cntr","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15840","name":"Nerve palsy fascial graft","description":"Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35082","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1923.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2246.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86807","name":"Cytotoxic antibody screening","description":"Serum screening for cytotoxic percent reactive antibody (pra); standard method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4651","name":"Calibrated microcap tube","description":"Calibrated microcapillary tube, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22870","name":"Insj stablj dev w/o dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26341","name":"Manipulat palm cord post inj","description":"Manipulation, palmar fascial cord (ie, dupuytrens cord), post enzyme injection (eg, collagenase), single cord","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77334","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11720","name":"Debride nail 1-5","description":"Debridement of nail(s) by any method(s); 1 to 5","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61558","name":"Excision of skull/sutures","description":"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563T","name":"Evac meibomian glnd heat bi","description":"Evacuation of meibomian glands, using heat delivered through wearable, open-eye eyelid treatment devices and manual gland expression, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34702","name":"Evasc rpr a-ao ndgft rpt","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1630.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33206","name":"Insert heart pm atrial","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4678.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80152","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72082","name":"X-ray exam entire spi 2/3 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86729","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15860","name":"Iv njx tst vasc flo flap/grf","description":"Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5962.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61314","name":"Crnec/crnot ittl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1668.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23190","name":"Ostectomy scapula partial","description":"Ostectomy of scapula, partial (eg, superior medial angle)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"Spirometry up to 2 yrs old","description":"Measurement of spirometric forced expiratory flows in an infant or child through 2 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46735","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1901.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52355","name":"Cystouretero w/excise tumor","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27506","name":"Treatment of thigh fracture","description":"Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or without cerclage and/or locking screws","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44850","name":"Repair of mesentery","description":"Suture of mesentery (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25301","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; extensors of fingers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32405","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92134","name":"Cptrz oph dx img pst sgm rta","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92520","name":"Laryngeal function studies","description":"Laryngeal function studies (ie, aerodynamic testing and acoustic testing)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27626","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle; including tenosynovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27818","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93571","name":"Iv dop vel&/press c flo 1st","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; initial vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49565","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27892","name":"Decompression of leg","description":"Decompression fasciotomy, leg; anterior and/or lateral compartments only, with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69540","name":"Excision aural polyp","description":"Excision aural polyp","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84481","name":"Free assay (ft-3)","description":"Triiodothyronine t3; free","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69636","name":"Rebuild eardrum structures","description":"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1115.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92130","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78804","name":"Rp loclzj tum whbdy 2+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53505","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; penile","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3035.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93464","name":"Exercise w/hemodynamic meas","description":"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11444","name":"Exc face-mm b9+marg 3.1-4 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59015","name":"Chorion biopsy","description":"Chorionic villus sampling, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94610","name":"Intrapulm surfactant admn","description":"Intrapulmonary surfactant administration by a physician or other qualified health care professional through endotracheal tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87529","name":"Hsv dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61570","name":"Remove foreign body brain","description":"Craniectomy or craniotomy; with excision of foreign body from brain","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1709.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3728.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74713","name":"Mri fetal ea addl gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50430","name":"Njx px nfrosgrm &/urtrgrm","description":"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55550","name":"Laparo ligate spermatic vein","description":"Laparoscopy, surgical, with ligation of spermatic veins for varicocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29823","name":"Sho arthrs srg xtnsv dbrdmt","description":"Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the ro","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36252","name":"Ins cath ren art 1st bilat","description":"Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and inte","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1232.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72148","name":"Mri lumbar spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43216","name":"Esophagoscopy lesion removal","description":"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75574","name":"Ct angio hrt w/3d image","description":"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92562","name":"Loudness balance test","description":"Loudness balance test, alternate binaural or monaural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9686","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47630","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45309","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63302","name":"Remove vert xdrl body thrlmb","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1996.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38305","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; extensive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15241","name":"Fth/gft f/c/c/m/n/a/g/h/f ea","description":"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33852","name":"Rpr hypopl a-arch wo byp","description":"Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98926","name":"Osteopath manj 3-4 regions","description":"Osteopathic manipulative treatment (omt); 3-4 body regions involved","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44372","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","name":"Anes px art fem art emblc","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery embolectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64472","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34501","name":"Repair valve femoral vein","description":"Valvuloplasty, femoral vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0271","name":"Group mnt 2 or more 30 mins","description":"Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","name":"Anes clsd ch mediast&thrc w/","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92548","name":"Cdp-sot 6 cond w/i&r","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":0.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87527","name":"Hepatitis g dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23146","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21040","name":"Excise mandible lesion","description":"Excision of benign tumor or cyst of mandible, by enucleation and/or curettage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20600","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0457","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33018","name":"Prcrd drg 0-5yr or w/anomly","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; birth through 5 years of age or any age with congenital cardiac anomaly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62142","name":"Rmvl b1 flp/prostc plate skl","description":"Removal of bone flap or prosthetic plate of skull","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":796.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5955.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":14696.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33858","name":"As-aort grf f/aortic dsj","description":"Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2964.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24065","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54162","name":"Lysis penil circumic lesion","description":"Lysis or excision of penile post-circumcision adhesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82608","name":"B-12 binding capacity","description":"Cyanocobalamin (vitamin b-12); unsaturated binding capacity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37250","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9982.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26561","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps and grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23675","name":"Cltx sho dislc neck fx mnpj","description":"Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11012","name":"Deb skin bone at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46604","name":"Anoscopy and dilation","description":"Anoscopy; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70492","name":"Ct sft tsue nck w/o & w/dye","description":"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8644.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4554.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50684","name":"Injection for ureter x-ray","description":"Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50750","name":"Fusion of ureter & kidney","description":"Ureterocalycostomy, anastomosis of ureter to renal calyx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65175","name":"Removal of ocular implant","description":"Removal of ocular implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33213","name":"Insert pulse gen dual leads","description":"Insertion of pacemaker pulse generator only; with existing dual leads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95145","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); single stinging insect venom","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45305","name":"Proctosigmoidoscopy w/bx","description":"Proctosigmoidoscopy, rigid; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37722","name":"Lig div&strpg long saph vein","description":"Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32402","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58956","name":"Bso omentectomy w/tah","description":"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64505","name":"N block spenopalatine gangl","description":"Injection, anesthetic agent; sphenopalatine ganglion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97024","name":"Diathermy eg microwave","description":"Application of a modality to 1 or more areas; diathermy (eg, microwave)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97150","name":"Group therapeutic procedures","description":"Therapeutic procedure(s), group (2 or more individuals)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"Venipuncture cutdown 1 yr/>","description":"Venipuncture, cutdown; age 1 or over","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42826","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; age 12 or over","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01232","name":"Anes opn px upr 2/3 fem amp","description":"Anesthesia for open procedures involving upper two-thirds of femur; amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31201","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27675","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; without fibular osteotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20102","name":"Expl pentrg wnd abd/flnk/bk","description":"Exploration of penetrating wound (separate procedure); abdomen/flank/back","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44626","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of hartmann type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1321.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33997","name":"Rmvl perq right heart vad","description":"Removal of percutaneous right heart ventricular assist device, venous cannula, at separate and distinct session from insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21209","name":"Reduction of facial bones","description":"Osteoplasty, facial bones; reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2406.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99354","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1649.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12020","name":"Tx supfc wnd dehsn smpl clsr","description":"Treatment of superficial wound dehiscence; simple closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27570","name":"Fixation of knee joint","description":"Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19084","name":"Bx breast add lesion us imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including ultrasound guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22510","name":"Perq cervicothoracic inject","description":"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522T","name":"Prgrmg dev eval wcs ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17315","name":"Mohs surg addl block","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), e","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29125","name":"Appl short arm splint static","description":"Application of short arm splint (forearm to hand); static","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33426","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2070.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99148","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11644","name":"Exc f/e/e/n/l mal+mrg 3.1-4","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75984","name":"Xray control catheter change","description":"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51960","name":"Revision of bladder & bowel","description":"Enterocystoplasty, including intestinal anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93786","name":"Ambl bp mntr w/sw rec only","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; recording only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66175","name":"Trluml dil aq o/f can w/st","description":"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); with retention of device or stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94452","name":"Hast w/i&r phys/qhp","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92563","name":"Tone decay hearing test","description":"Tone decay test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69502","name":"Mastoidectomy","description":"Mastoidectomy; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54115","name":"Treatment of penis lesion","description":"Removal foreign body from deep penile tissue (eg, plastic implant)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40019.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69145","name":"Remove ear canal lesion(s)","description":"Excision soft tissue lesion, external auditory canal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32671","name":"Thoracoscopy pneumonectomy","description":"Thoracoscopy, surgical; with removal of lung (pneumonectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1423.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1853.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":977.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52204","name":"Cystoscopy w/biopsy(s)","description":"Cystourethroscopy, with biopsy(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53445","name":"Insert uro/ves nck sphincter","description":"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35458","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62310","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83670","name":"Assay of lap enzyme","description":"Leucine aminopeptidase (lap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45340","name":"Sig w/tndsc balloon dilation","description":"Sigmoidoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69714","name":"Impl oi implt skull perq esp","description":"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63741","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20938","name":"Sp bone agrft struct add-on","description":"Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial incision) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62200","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy, third ventricle;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4183.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76942","name":"Echo guide for biopsy","description":"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41153","name":"Tongue mouth neck surgery","description":"Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11976","name":"Remove contraceptive capsule","description":"Removal, implantable contraceptive capsules","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92325","name":"Modification of contact lens","description":"Modification of contact lens (separate procedure), with medical supervision of adaptation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87635","name":"Sars-cov-2 covid-19 amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39220","name":"Resect mediastinal tumor","description":"Resection of mediastinal tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86226","name":"Dna antibody single strand","description":"Deoxyribonucleic acid (dna) antibody; single stranded","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","name":"Anes integ sys conv arrhyt","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1608.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11045","name":"Dbrdmt subq tiss each addl","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8244.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78708","name":"K flow/funct image w/drug","description":"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75559","name":"Cardiac mri w/stress img","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0148","name":"Scr c/v cyto, autosys, rescr","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99491","name":"Chrnc care mgmt phys 1st 30","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93318","name":"Echo transesophageal intraop","description":"Echocardiography, transesophageal (tee) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17286","name":"Dstr mal ls f/e/e/n/l/m>4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53230","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); female","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70557","name":"Mri brain w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72082","name":"X-ray exam entire spi 2/3 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65860","name":"Severing ads ant sgm laser","description":"Severing adhesions of anterior segment, laser technique (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21610","name":"Costotransversectomy","description":"Costotransversectomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1607.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25651","name":"Perq skel fix ulnar styld fx","description":"Percutaneous skeletal fixation of ulnar styloid fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54348","name":"Rpr hypspad comp dsj & urtp","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4589.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32420","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80196","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69300","name":"Revise external ear","description":"Otoplasty, protruding ear, with or without size reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8908","name":"Mri w/o fol w/cont, breast,","description":"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27759","name":"Treatment of tibia fracture","description":"Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without interlocking screws and/or cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29843","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; for infection, lavage and drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2116.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1667.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L6025","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3897.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95180","name":"Rapid desensitization","description":"Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27603","name":"Drain lower leg lesion","description":"Incision and drainage, leg or ankle; deep abscess or hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75902","name":"Remove cva lumen obstruct","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26553","name":"Single transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2772.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51703","name":"Insert bladder cath complex","description":"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25525","name":"Optx rdl shft fx&cltx rad/ul","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed, and closed treatment of distal radioulnar joint dislocation (galeazzi fracture/ dislocation), includes percutaneous skeletal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61576","name":"Skull base/brainstem surgery","description":"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3832.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36140","name":"Intro ndl icath upr/lxtr art","description":"Introduction of needle or intracatheter, upper or lower extremity artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32036","name":"Thoracostomy w/flap drainage","description":"Thoracostomy; with open flap drainage for empyema","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96103","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69440","name":"Exploration of middle ear","description":"Middle ear exploration through postauricular or ear canal incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57456","name":"Endocerv curettage w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44397","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43101","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69436","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35485","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4522","name":"Adult size brief/diaper med","description":"Adult sized disposable incontinence product, brief/diaper, medium, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35682","name":"Composite byp grft 2 veins","description":"Bypass graft; autogenous composite, 2 segments of veins from 2 locations (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65290","name":"Repair of eye socket wound","description":"Repair of wound, extraocular muscle, tendon and/or tenons capsule","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93224","name":"Xtrnl ecg rec up to 48 hrs","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27194","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","name":"Anes art sho&ax ax-fem bpg","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4176","name":"Parenteral sol amino acid 7-","description":"Parenteral nutrition solution; amino acid, 7% through 8.5%, (500 ml = 1 unit) - home mix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97532","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93986","name":"Dup-scan hemo compl uni std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9615","name":"Urine specimen collect mult","description":"Catheterization for collection of specimen(s) (multiple patients)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24500","name":"Cltx humrl shft fx w/o mnpj","description":"Closed treatment of humeral shaft fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27707","name":"Osteotomy fibula","description":"Osteotomy; fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29897","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83785","name":"Assay of manganese","description":"Manganese","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27443","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32609","name":"Thoracoscopy w/bx pleura","description":"Thoracoscopy; with biopsy(ies) of pleura","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77049","name":"Mri breast c-+ w/cad bi","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4209","name":"5+ cc sterile syringe&needle","description":"Syringe with needle, sterile 5 cc or greater, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26010","name":"Drainage of finger abscess","description":"Drainage of finger abscess; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15835","name":"Exc excessive skin buttock","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25246","name":"Injection for wrist x-ray","description":"Injection procedure for wrist arthrography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88148","name":"Cytopath c/v auto rescreen","description":"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61597","name":"Transcondylar approach/skull","description":"Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of c1-c3 vertebral body(s), decompression of vertebral artery, with or without mobilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2661.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1732.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":804.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1412.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28264","name":"Release of midfoot joint","description":"Capsulotomy, midtarsal (eg, heyman type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62148","name":"Retr bone flap to fix skull","description":"Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78800","name":"Rp loclzj tum 1 area 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92133","name":"Cptrzd oph dx img pst sgm on","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; optic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20660","name":"Apply rem fixation device","description":"Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76140","name":"X-ray consultation","description":"Consultation on x-ray examination made elsewhere, written report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36825","name":"Artery-vein autograft","description":"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96112","name":"Devel tst phys/qhp 1st hr","description":"Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58146","name":"Myomectomy abdom complex","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26420","name":"Repair/graft finger tendon","description":"Repair, extensor tendon, finger, primary or secondary; with free graft (includes obtaining graft) each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0307","name":"Cbc without platelet","description":"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85335","name":"Factor inhibitor test","description":"Factor inhibitor test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58262","name":"Vag hyst including t/o","description":"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76937","name":"Us guide vascular access","description":"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72081","name":"X-ray exam entire spi 1 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81337","name":"Smn1 gen nown famil seq vrnt","description":"Smn1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3049.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99157","name":"Mod sed other phys/qhp ea","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; each additional 15 minutes intraservice time (list separate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27356","name":"Remove femur lesion/graft","description":"Excision or curettage of bone cyst or benign tumor of femur; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2559.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5508","name":"Diabetic deluxe shoe","description":"For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80412","name":"Crh stimulation panel","description":"Corticotropic releasing hormone (crh) stimulation panel this panel must include the following: cortisol (82533 x 6) adrenocorticotropic hormone (acth) (82024 x 6)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KC"]},{"negotiated_type":"negotiated","negotiated_rate":3524.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45387","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P7001","name":"Culture bacterial urine","description":"Culture, bacterial, urine; quantitative, sensitivity study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46610","name":"Anoscopy remove lesion","description":"Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96922","name":"Excimer lsr psriasis>500sqcm","description":"Excimer laser treatment for psoriasis; over 500 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15777","name":"Acellular derm matrix implt","description":"Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (ie, breast, trunk) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64620","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, intercostal nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21029","name":"Contour of face bone lesion","description":"Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0414","name":"Pelvic ring fx treat int fix","description":"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1940.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","name":"Anes trurl px urtrl cal rmvl","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87279","name":"Parainfluenza ag if","description":"Infectious agent antigen detection by immunofluorescent technique; parainfluenza virus, each type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33676","name":"Close mult vsd w/resection","description":"Closure of multiple ventricular septal defects; with pulmonary valvotomy or infundibular resection (acyanotic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1760.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13101","name":"Cmplx rpr trunk 2.6-7.5 cm","description":"Repair, complex, trunk; 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32505","name":"Wedge resect of lung initial","description":"Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27062","name":"Remove femur lesion/bursa","description":"Excision; trochanteric bursa or calcification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11900","name":"Inject skin lesions </w 7","description":"Injection, intralesional; up to and including 7 lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29901","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with debridement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19342","name":"Insj/rplcmt brst implt sep d","description":"Insertion or replacement of breast implant on separate day from mastectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64600","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64577","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45171","name":"Exc rect tum transanal part","description":"Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93456","name":"R hrt coronary artery angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20665","name":"Rmvl tongs/halo anthr indiv","description":"Removal of tongs or halo applied by another individual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0243","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89055","name":"Leukocyte assessment fecal","description":"Leukocyte assessment, fecal, qualitative or semiquantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12013","name":"Rpr f/e/e/n/l/m 2.6-5.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3461.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9686","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33233","name":"Removal of pm generator","description":"Removal of permanent pacemaker pulse generator only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36002","name":"Pseudoaneurysm injection trt","description":"Injection procedures (eg, thrombin) for percutaneous treatment of extremity pseudoaneurysm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87503","name":"Influenza dna amp prob addl","description":"Infectious agent detection by nucleic acid (dna or rna); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, each additional influenza virus type or sub-type beyond 2 (list separately in addition to code","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95800","name":"Slp stdy unattended","description":"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83885","name":"Assay of nickel","description":"Nickel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86768","name":"Salmonella antibody","description":"Antibody; salmonella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55180","name":"Revision of scrotum","description":"Scrotoplasty; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84270","name":"Assay of sex hormone globul","description":"Sex hormone binding globulin (shbg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86336","name":"Inhibin a","description":"Inhibin a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78802","name":"Rp loclzj tum whbdy 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95936","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3093.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01430","name":"Anes px veins knee&pop nos","description":"Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28435","name":"Cltx talus fracture w/mnpj","description":"Closed treatment of talus fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36800","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","name":"Anes c hyst flwg neuraxial","description":"Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92650","name":"Aep scr auditory potential","description":"Auditory evoked potentials; screening of auditory potential with broadband stimuli, automated analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29894","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62190","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86768","name":"Salmonella antibody","description":"Antibody; salmonella","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90812","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73502","name":"X-ray exam hip uni 2-3 views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4722","name":"Dialys sol fld vol > 1999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56700","name":"Prtl hymnctmy/revj hymnl rng","description":"Partial hymenectomy or revision of hymenal ring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63301","name":"Remove vert xdrl body thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2020.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87269","name":"Giardia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; giardia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25109","name":"Excise tendon forearm/wrist","description":"Excision of tendon, forearm and/or wrist, flexor or extensor, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93283","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantab","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93299","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0282","name":"Elect stim wound care not pd","description":"Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7929.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78464","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59618","name":"Attempted vbac delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2108.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33951","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20551","name":"Njx 1 tendon origin/insj","description":"Injection(s); single tendon origin/insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22548","name":"Arthrd ant toral/xoral c1-c2","description":"Arthrodesis, anterior transoral or extraoral technique, clivus-c1-c2 (atlas-axis), with or without excision of odontoid process","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4150","name":"Ef complet w/intact nutrient","description":"Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92014","name":"Compre oph exam est pt 1/>","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37140","name":"Revision of circulation","description":"Venous anastomosis, open; portocaval","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2045.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33476","name":"Revision of heart chamber","description":"Right ventricular resection for infundibular stenosis, with or without commissurotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1319.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51797","name":"Intraabdominal pressure test","description":"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82731","name":"Assay of fetal fibronectin","description":"Fetal fibronectin, cervicovaginal secretions, semi-quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2800.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47480","name":"Incision of gallbladder","description":"Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27331","name":"Explore/treat knee joint","description":"Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54015","name":"I&d penis deep","description":"Incision and drainage of penis, deep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23655","name":"Cltx sho dslc w/mnpj w/anes","description":"Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93724","name":"Elec alys antitchycar pm sys","description":"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81185","name":"Cacna1a gene full gene seq","description":"Cacna1a (calcium voltage-gated channel subunit alpha1 a) (eg, spinocerebellar ataxia) gene analysis; full gene sequence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63064","name":"Decompress spinal cord thrc","description":"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27403","name":"Repair of knee cartilage","description":"Arthrotomy with meniscus repair, knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43251","name":"Egd remove lesion snare","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63662","name":"Remove spine eltrd plate","description":"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17282","name":"Dstr mal ls f/e/e/n/l/m1.1-2","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9561","name":"Tc99m oxidronate","description":"Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37253","name":"Intrvasc us noncoronary addl","description":"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42660","name":"Dilation of salivary duct","description":"Dilation and catheterization of salivary duct, with or without injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67228","name":"Treatment x10sv retinopathy","description":"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49540","name":"Repair lumbar hernia","description":"Repair lumbar hernia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01190","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28124","name":"Partial removal of toe","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); phalanx of toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25526","name":"Optx rdl shft fx&dstl rad/ul","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (galeazzi fracture/ dislocation), includes internal fixation, when performed, includes repair of triangular fibrocartilage complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46942","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11762","name":"Reconstruction of nail bed","description":"Reconstruction of nail bed with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1874","name":"Stent, coated/cov w/del sys","description":"Stent, coated/covered, with delivery system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3310.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4471.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67025","name":"Replace eye fluid","description":"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31530","name":"Laryngoscopy w/fb removal","description":"Laryngoscopy, direct, operative, with foreign body removal;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72081","name":"X-ray exam entire spi 1 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77078","name":"Ct bone density axial","description":"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4231","name":"Infusion insulin pump needle","description":"Infusion set for external insulin pump, needle type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80430","name":"Growth hormone panel","description":"Growth hormone suppression panel (glucose administration) this panel must include the following: glucose (82947 x 3) human growth hormone (hgh) (83003 x 4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29844","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40814","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50650","name":"Removal of ureter","description":"Ureterectomy, with bladder cuff (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24201","name":"Rmvl fb upper arm/elbw deep","description":"Removal of foreign body, upper arm or elbow area; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31520","name":"Dx laryngoscopy newborn","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, newborn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35189","name":"Rpr acq av fistula thrx&abd","description":"Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27424","name":"Revision/removal of kneecap","description":"Reconstruction of dislocating patella; with patellectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0544T","name":"Tcat mv annulus rcnstj","description":"Transcatheter mitral valve annulus reconstruction, with implantation of adjustable annulus reconstruction device, percutaneous approach including transseptal puncture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80055","name":"Obstetric panel","description":"Obstetric panel this panel must include the following: blood count, complete (cbc), automated and automated differential wbc count (85025 or 85027 and 85004) or blood count, complete (cbc), automated (85027) and appropriate manual differential wbc count (85007 or 85009) hepatitis b surface antigen (","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27252","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15002","name":"Wound prep trk/arm/leg","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92564","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33924","name":"Remove pulmonary shunt","description":"Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37215","name":"Transcath stent cca w/eps","description":"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82965","name":"Assay of gdh enzyme","description":"Glutamate dehydrogenase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36823","name":"Insertion of cannula(s)","description":"Insertion of arterial and venous cannula(s) for isolated extracorporeal circulation including regional chemotherapy perfusion to an extremity, with or without hyperthermia, with removal of cannula(s) and repair of arteriotomy and venotomy sites","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26587","name":"Reconstruct extra finger","description":"Reconstruction of polydactylous digit, soft tissue and bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88333","name":"Path consltj surg cyto xm 1","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86806","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; without titration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","name":"Anes px fcl b1/skl rad surg","description":"Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21685","name":"Hyoid myotomy & suspension","description":"Hyoid myotomy and suspension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35450","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93456","name":"R hrt coronary artery angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1668.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49215","name":"Excise sacral spine tumor","description":"Excision of presacral or sacrococcygeal tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1824.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34844","name":"Endovasc visc aorta 4 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1632.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32664","name":"Thoracoscopy w/ th nrv exc","description":"Thoracoscopy, surgical; with thoracic sympathectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15830","name":"Exc excessive skin abdomen","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45386","name":"Colonoscopy w/balloon dilat","description":"Colonoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22524","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5831.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85441","name":"Heinz bodies direct","description":"Heinz bodies; direct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43193","name":"Esophagoscp rig trnso biopsy","description":"Esophagoscopy, rigid, transoral; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93640","name":"Ep eval 1/2chmbr pacg cvdfb","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75662","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50392","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77523","name":"Proton trmt intermediate","description":"Proton treatment delivery; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89160","name":"Exam feces for meat fibers","description":"Meat fibers, feces","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62165","name":"Remove pituit tumor w/scope","description":"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1289.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64713","name":"Revision of arm nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27756","name":"Treatment of tibia fracture","description":"Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (eg, pins or screws)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55812","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80100","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19306","name":"Mast rad urban type","description":"Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph nodes (urban type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4270","name":"Disposable endoscope sheath","description":"Disposable endoscope sheath, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54700","name":"I&d epdidyms tstis&/scrot sp","description":"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0243","name":"Toilet rail","description":"Toilet rail, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53400","name":"Revise urethra stage 1","description":"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, johannsen type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1294.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23130","name":"Acromp/acromionectomy prtl","description":"Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87528","name":"Hsv dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78596","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88274","name":"Cytogenetics 25-99","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2084.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67415","name":"Aspiration orbital contents","description":"Fine needle aspiration of orbital contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86430","name":"Rheumatoid factor test qual","description":"Rheumatoid factor; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42806","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, survey for unknown primary lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35558","name":"Art byp grft fem-femoral","description":"Bypass graft, with vein; femoral-femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51700","name":"Irrigation of bladder","description":"Bladder irrigation, simple, lavage and/or instillation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31530","name":"Laryngoscopy w/fb removal","description":"Laryngoscopy, direct, operative, with foreign body removal;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78803","name":"Rp loclzj tum spect 1 area","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66830","name":"Removal of lens lesion","description":"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81239","name":"Dmpk gene charac alleles","description":"Dmpk (dm1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32554","name":"Aspirate pleura w/o imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54650","name":"Orchiopexy (fowler-stephens)","description":"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, fowler-stephens)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31647","name":"Bronchial valve init insert","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58958","name":"Resc recr ovr tbl pp utr mal","description":"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy and limited para-aortic lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93745","name":"Set-up cardiovert-defibrill","description":"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ecg, transmission of data to data repository, patient instruction in wearing system and patient re","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87230","name":"Toxin/antitoxin asy tiss cul","description":"Toxin or antitoxin assay, tissue culture (eg, clostridium difficile toxin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1597.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3588.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15131","name":"Drm agrft t/a/l ea addl","description":"Dermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64727","name":"Internal neurolysis","description":"Internal neurolysis, requiring use of operating microscope (list separately in addition to code for neuroplasty) (neuroplasty includes external neurolysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71551","name":"Mri chest w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75945","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27098","name":"Transfer tendon to pelvis","description":"Transfer, adductor to ischium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64412","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68520","name":"Removal of tear sac","description":"Excision of lacrimal sac (dacryocystectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3846.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74175","name":"Cta abdomen w/contrast","description":"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1870.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7830.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36597","name":"Reposition venous catheter","description":"Repositioning of previously placed central venous catheter under fluoroscopic guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95939","name":"C motor evoked upr&lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43460","name":"Pressure treatment esophagus","description":"Esophagogastric tamponade, with balloon (sengstaken type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85175","name":"Blood clot lysis time","description":"Clot lysis time, whole blood dilution","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84150","name":"Assay of prostaglandin","description":"Prostaglandin, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27506","name":"Treatment of thigh fracture","description":"Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or without cerclage and/or locking screws","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","name":"Anes hrna rpr lmbr&vnt&/dehs","description":"Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20924","name":"Removal of tendon for graft","description":"Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85280","name":"Clot factor xii hageman","description":"Clotting; factor xii (hageman)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11770","name":"Exc pilonidal cyst simple","description":"Excision of pilonidal cyst or sinus; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24538","name":"Prq skel fix sprcndlr hum fx","description":"Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63196","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1627.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78432","name":"Myocrd img pet 2rtracer","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2170.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8053.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6549","name":"Grad com garm noc day use","description":"Gradient compression garment, not otherwise specified, for daytime use, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61530","name":"Removal of brain lesion","description":"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85130","name":"Chromogenic substrate assay","description":"Chromogenic substrate assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50725","name":"Release/revise ureter","description":"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00740","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25075","name":"Exc forearm les sc < 3 cm","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11420","name":"Exc h-f-nk-sp b9+marg 0.5/<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41828","name":"Excision of gum lesion","description":"Excision of hyperplastic alveolar mucosa, each quadrant (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33340","name":"Perq clsr tcat l atr apndge","description":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1790.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22632","name":"Arthrd pst tq 1ntrspc lm ea","description":"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3673","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97597","name":"Dbrdmt opn wnd 1st 20 cm/<","description":"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when perform","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6978.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88264","name":"Chromosome analysis 20-25","description":"Chromosome analysis; analyze 20-25 cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95872","name":"Ndl emg single fiber eltrd","description":"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36660","name":"Insertion catheter artery","description":"Catheterization, umbilical artery, newborn, for diagnosis or therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25210","name":"Removal of wrist bone","description":"Carpectomy; 1 bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95709","name":"Eeg w/o vid ea 12-26hr intmt","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, each increment of 12-26 hours; with intermittent monitoring and maintenance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88332","name":"Path consltj surg ea add blk","description":"Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":55.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44120","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; single resection and anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83825","name":"Assay of mercury","description":"Mercury, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52287","name":"Cystoscopy chemodenervation","description":"Cystourethroscopy, with injection(s) for chemodenervation of the bladder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91035","name":"G-esoph reflx tst w/electrod","description":"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry ph electrode placement, recording, analysis and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83516","name":"Immunoassay nonantibody","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48150","name":"Partial removal of pancreas","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); with pancreatojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2609.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64783","name":"Limb nerve surgery add-on","description":"Excision of neuroma; hand or foot, each additional nerve, except same digit (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41018","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45800","name":"Repair rect/bladder fistula","description":"Closure of rectovesical fistula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","name":"Anes maj lwr adb vsl ivc lig","description":"Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84377","name":"Sugars multiple qual","description":"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","name":"Anes integ sys rcnstv breast","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34831","name":"Open aortoiliac prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bi-iliac prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1702.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35860","name":"Explore limb vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85400","name":"Fibrinolytic plasmin","description":"Fibrinolytic factors and inhibitors; plasmin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92588","name":"Evoked auditory tst complete","description":"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61334","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43285","name":"Rmvl esophgl sphnctr dev","description":"Removal of esophageal sphincter augmentation device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55540","name":"Revise hernia & sperm veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62163","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93459","name":"L hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter place","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75989","name":"Abscess drainage under x-ray","description":"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57330","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; transvesical and vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26600","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; without manipulation, each bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27680","name":"Release of lower leg tendon","description":"Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51727","name":"Cystometrogram w/up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50382","name":"Change ureter stent percut","description":"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35683","name":"Composite byp grft 3/> segmt","description":"Bypass graft; autogenous composite, 3 or more segments of vein from 2 or more locations (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15272","name":"Skin sub graft t/a/l add-on","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26416","name":"Graft hand or finger tendon","description":"Removal of synthetic rod and insertion of extensor tendon graft (includes obtaining graft), hand or finger, each rod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42330","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45116","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; transsacral approach only (kraske type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91035","name":"G-esoph reflx tst w/electrod","description":"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry ph electrode placement, recording, analysis and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8460","name":"Camisole post-mast","description":"Camisole, post-mastectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95885","name":"Musc tst done w/nerv tst lim","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78593","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19298","name":"Place breast rad tube/caths","description":"Placement of radiotherapy after loading brachytherapy catheters (multiple tube and button type) into the breast for interstitial radioelement application following (at the time of or subsequent to) partial mastectomy, includes imaging guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27256","name":"Treat hip dislocation","description":"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; without anesthesia, without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77316","name":"Brachytx isodose plan simple","description":"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87169","name":"Macroscopic exam parasite","description":"Macroscopic examination; parasite","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90863","name":"Pharmacologic mgmt w/psytx","description":"Pharmacologic management, including prescription and review of medication, when performed with psychotherapy services (list separately in addition to the code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56633","name":"Vulvectomy radical complete","description":"Vulvectomy, radical, complete;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95972","name":"Alys cplx sp/pn npgt w/prgrm","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42320","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary, external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38101","name":"Removal of spleen partial","description":"Splenectomy; partial (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"18583","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43325","name":"Revise esophagus & stomach","description":"Esophagogastric fundoplasty, with fundic patch (thal-nissen procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1139.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86727","name":"Lymph choriomeningitis ab","description":"Antibody; lymphocytic choriomeningitis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0435","name":"Oral hiv-1/hiv-2 screen","description":"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21127","name":"Augmentation mndblr b1 grf","description":"Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3259.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"Vnpnxr<3yrs phy/qhp scalp vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; scalp vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82654","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81181","name":"Atxn7 gene detc abnor allele","description":"Atxn7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0247T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71275","name":"Ct angiography chest","description":"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2869.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3137.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13160","name":"Sec clsr surg wnd/dehsn xtn","description":"Secondary closure of surgical wound or dehiscence, extensive or complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2032.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35535","name":"Art byp grft hepatorenal","description":"Bypass graft, with vein; hepatorenal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1684.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92012","name":"Intrm oph exam est patient","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":67.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23460","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with bone block","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44380","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53415","name":"Reconstruction of urethra","description":"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":914.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59620","name":"Attempted vbac delivery only","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2472.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31575","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, flexible; diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78832","name":"Rp loclzj tum spect w/ct 2","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27003","name":"Tnot adductr subq opn neurct","description":"Tenotomy, adductor, subcutaneous, open, with obturator neurectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6233.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78481","name":"Heart first pass single","description":"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56631","name":"Vlvctmy rad prtl uni lymphad","description":"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24359","name":"Repair elbow deb/attch open","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); debridement, soft tissue and/or bone, open with tendon repair or reattachment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44316","name":"Devise bowel pouch","description":"Continent ileostomy (kock procedure) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1186.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82575","name":"Creatinine clearance test","description":"Creatinine; clearance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","name":"Anes male gent compl amp pns","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); complete amputation of penis","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4590","name":"Special casting material","description":"Special casting material (e.g., fiberglass)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3608.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","name":"Anes hrna rpr upr abd nos","description":"Anesthesia for hernia repairs in upper abdomen; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58805","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1431.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32668","name":"Thoracoscopy w/w resect diag","description":"Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33694","name":"Cmp rpr tof wo plm atrs ptch","description":"Complete repair tetralogy of fallot without pulmonary atresia; with transannular patch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1698.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67974","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95831","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0130","name":"Single energy x-ray study","description":"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0248","name":"Demonstrate use home inr mon","description":"Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87903","name":"Phenotype dna hiv w/culture","description":"Infectious agent phenotype analysis by nucleic acid (dna or rna) with drug resistance tissue culture analysis, hiv 1; first through 10 drugs tested","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3899.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93312","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58572","name":"Tlh uterus over 250 g","description":"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93892","name":"Tcd emboli detect w/o inj","description":"Transcranial doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99486","name":"Suprv interfac trnsport addl","description":"Supervision by a control physician of interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with transport team before transport, at the referring facility and during the transport, including data inter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99489","name":"Cplx chrnc care ea addl 30","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74210","name":"X-ray xm phrnx&/crv esoph c+","description":"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0202U","name":"Nfct ds 22 trgt sars-cov-2","description":"Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (dna or rna), 22 targets including severe acute respiratory syndrome coronavirus 2 (sars-cov-2), qualitative rt-pcr, nasopharyngeal swab, each pathogen reported as detected or not detected","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33969","name":"Ecmo/ecls rmvl perph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3997.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51555","name":"Partial removal of bladder","description":"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0513","name":"Prolong prev svcs, first 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86301","name":"Immunoassay tumor ca 19-9","description":"Immunoassay for tumor antigen, quantitative; ca 19-9","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45170","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98970","name":"Nqhp ol dig assmt&mgmt 5-10","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67105","name":"Repair detached retina pc","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61591","name":"Infratemporal approach/skull","description":"Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resection of sigmoid sinus, with or without decompression and/or mobilization of contents of auditory cana","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2611.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81320","name":"Plcg2 gene common variants","description":"Plcg2 (phospholipase c gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, r665w, s707f, l845f)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68700","name":"Repair tear ducts","description":"Plastic repair of canaliculi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75574","name":"Ct angio hrt w/3d image","description":"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38120","name":"Laparoscopy splenectomy","description":"Laparoscopy, surgical, splenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20930","name":"Sp bone algrft morsel add-on","description":"Allograft, morselized, or placement of osteopromotive material, for spine surgery only (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61611","name":"Transect artery sinus","description":"Transection or ligation, carotid artery in petrous canal; without repair (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32663","name":"Thoracoscopy w/lobectomy","description":"Thoracoscopy, surgical; with lobectomy (single lobe)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64738","name":"Incision of jaw nerve","description":"Transection or avulsion of; inferior alveolar nerve by osteotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25900","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35700","name":"Reoperation bypass graft","description":"Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":667.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33310","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); without bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":137.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88375","name":"Optical endomicroscpy interp","description":"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10140","name":"I&d hmtma seroma/fluid collj","description":"Incision and drainage of hematoma, seroma or fluid collection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87197","name":"Serum bactericidal titer","description":"Serum bactericidal titer (schlichter test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55920","name":"Place needles pelvic for rt","description":"Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31295","name":"Nsl/sins ndsc surg max sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); maxillary sinus ostium, transnasal or via canine fossa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36800","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82136","name":"Amino acids quant 2-5","description":"Amino acids, 2 to 5 amino acids, quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78414","name":"Non-imaging heart function","description":"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73523","name":"X-ray exam hips bi 5/> views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38747","name":"Remove abdominal lymph nodes","description":"Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2307.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0248","name":"Demonstrate use home inr mon","description":"Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33720","name":"Repair of heart defect","description":"Repair sinus of valsalva aneurysm, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2201.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92613","name":"Endoscopy swallow (fees) i&r","description":"Flexible endoscopic evaluation of swallowing by cine or video recording; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3254","name":"Orth foot non-stndard size/w","description":"Non-standard size or width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61140","name":"Burr hole/treph bx brain/les","description":"Burr hole(s) or trephine; with biopsy of brain or intracranial lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94070","name":"Evaluation of wheezing","description":"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21423","name":"Optx palatal/max fx comp","description":"Open treatment of palatal or maxillary fracture (lefort i type); complicated (comminuted or involving cranial nerve foramina), multiple approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4590","name":"Special casting material","description":"Special casting material (e.g., fiberglass)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50544","name":"Laparoscopy pyeloplasty","description":"Laparoscopy, surgical; pyeloplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","KL","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33214","name":"Upgrade of pacemaker system","description":"Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":218.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88331","name":"Path consltj surg 1 blk 1spc","description":"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30420","name":"Reconstruction of nose","description":"Rhinoplasty, primary; including major septal repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29847","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; internal fixation for fracture or instability","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49501","name":"Rpr ing hernia init blocked","description":"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61611","name":"Transect artery sinus","description":"Transection or ligation, carotid artery in petrous canal; without repair (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2549.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94003","name":"Vent mgmt inpat subq day","description":"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, each subsequent day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15781","name":"Dermabrasion segmental face","description":"Dermabrasion; segmental, face","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63017","name":"Remove spine lamina >2 lmbr","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26035","name":"Decompress fingers/hand","description":"Decompression fingers and/or hand, injection injury (eg, grease gun)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26715","name":"Treat knuckle dislocation","description":"Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83030","name":"Hemoglobin f fetal chemical","description":"Hemoglobin; f (fetal), chemical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["AV","AU","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27756","name":"Treatment of tibia fracture","description":"Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (eg, pins or screws)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72157","name":"Mri chest spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84100","name":"Assay of phosphorus","description":"Phosphorus inorganic (phosphate);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11201","name":"Rmvl skin tags ea addl 10","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22220","name":"Osteot dsc ant 1 vrt sgm crv","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83069","name":"Hemoglobin urine","description":"Hemoglobin; urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78709","name":"K flow/funct image multiple","description":"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2565.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35341","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, or renal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1211.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86628","name":"Candida antibody","description":"Antibody; candida","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4210","name":"Orth dev repair/repl minor p","description":"Repair of orthotic device, repair or replace minor parts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41145","name":"Tongue removal neck surgery","description":"Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2140.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40840","name":"Reconstruction of mouth","description":"Vestibuloplasty; anterior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1414.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29425","name":"Appl short leg cast walking","description":"Application of short leg cast (below knee to toes); walking or ambulatory type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38573","name":"Laps pelvic lymphadec","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3150.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84580","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; quantitative, timed specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84488","name":"Test feces for trypsin","description":"Trypsin; feces, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25442","name":"Arthrp w/prostc dstl ulna","description":"Arthroplasty with prosthetic replacement; distal ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29720","name":"Repair spica body cst/jacket","description":"Repair of spica, body cast or jacket","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99488","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42104","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; without closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92132","name":"Cptrzd oph dx img ant sgm","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), anterior segment, with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31259","name":"Nsl/sins ndsc sphn tiss rmvl","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80188","name":"Assay of primidone","description":"Primidone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85302","name":"Clot inhibit prot c antigen","description":"Clotting inhibitors or anticoagulants; protein c, antigen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64910","name":"Nerve repair w/allograft","description":"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4337.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27768","name":"Cltx post ankle fx w/mnpj","description":"Closed treatment of posterior malleolus fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78586","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6260","name":"Wound cleanser any type/size","description":"Wound cleansers, any type, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27485","name":"Surgery to stop leg growth","description":"Arrest, hemiepiphyseal, distal femur or proximal tibia or fibula (eg, genu varus or valgus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1499","name":"Spinal orthosis nos","description":"Spinal orthosis, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29540","name":"Strapping ankle &/foot","description":"Strapping; ankle and/or foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34841","name":"Endovasc visc aorta 1 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64580","name":"Opn impltj nea neuromuscular","description":"Open implantation of neurostimulator electrode array; neuromuscular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31612","name":"Perq trchl pnxr ttrach aspir","description":"Tracheal puncture, percutaneous with transtracheal aspiration and/or injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90467","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86790","name":"Virus antibody nos","description":"Antibody; virus, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83727","name":"Assay of lrh hormone","description":"Luteinizing releasing factor (lrh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59525","name":"Remove uterus after cesarean","description":"Subtotal or total hysterectomy after cesarean delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81327","name":"Sept9 gen prmtr mthyltn alys","description":"Sept9 (septin9) (eg, colorectal cancer) promoter methylation analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87278","name":"Legion pneumophilia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; legionella pneumophila","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96170","name":"Hlth bhv ivntj fam wo pt 1st","description":"Health behavior intervention, family (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33513","name":"Cabg vein four","description":"Coronary artery bypass, vein only; 4 coronary venous grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2157.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0147","name":"Scr c/v cyto, automated sys","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44403","name":"Colonoscopy w/resection","description":"Colonoscopy through stoma; with endoscopic mucosal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37253","name":"Intrvasc us noncoronary addl","description":"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87625","name":"Hpv types 16 & 18 only","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), types 16 and 18 only, includes type 45, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68760","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70488","name":"Ct maxillofacial w/o & w/dye","description":"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66184","name":"Revision of aqueous shunt","description":"Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67875","name":"Closure of eyelid by suture","description":"Temporary closure of eyelids by suture (eg, frost suture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33500","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1354.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93291","name":"Interrog dev eval scrms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; subcutaneous cardiac rhythm monitor system, including heart rhythm derived data analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","name":"Anes hernia repair<1 yr age","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, younger than 1 year of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31588","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68801.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5441.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1831.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":965.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20396.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54324","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0481","name":"Drug test def 8-14 classes","description":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78802","name":"Rp loclzj tum whbdy 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","AV","AU","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4155","name":"Ef incomplete/modular","description":"Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 un","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80168","name":"Assay of ethosuximide","description":"Ethosuximide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0237T","name":"Trluml perip athrc brchiocph","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; brachiocephalic trunk and branches, each vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9507.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92549","name":"Cdp-sot 6 cond w/i&r mct&adt","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (mct) and adaptation test (adt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74247","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31255","name":"Nsl/sins ndsc w/tot ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93745","name":"Set-up cardiovert-defibrill","description":"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ecg, transmission of data to data repository, patient instruction in wearing system and patient re","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82492","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1951.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KM","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0404","name":"Ekg tracing for initial prev","description":"Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58825","name":"Transposition ovary(s)","description":"Transposition, ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32651","name":"Thoracoscopy remove cortex","description":"Thoracoscopy, surgical; with partial pulmonary decortication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58520","name":"Repair of ruptured uterus","description":"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99201","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36015","name":"Place catheter in artery","description":"Selective catheter placement, segmental or subsegmental pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27416","name":"Osteochondral knee autograft","description":"Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograft[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21453","name":"Cltx mndblr fx ntrdntl fixj","description":"Closed treatment of mandibular fracture with interdental fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92538","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93620","name":"Comp ep evl r at ven pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1166.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11954","name":"Subq njx fil matrl>10.0 cc","description":"Subcutaneous injection of filling material (eg, collagen); over 10.0 cc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99233","name":"Sbsq hosp ip/obs high 50","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes m","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92504","name":"Ear microscopy examination","description":"Binocular microscopy (separate diagnostic procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44155","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, with proctectomy; with ileostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1682.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64776","name":"Remove digit nerve lesion","description":"Excision of neuroma; digital nerve, 1 or both, same digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65140","name":"Attach ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles attached to implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP10","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23440","name":"Remove/transplant tendon","description":"Resection or transplantation of long tendon of biceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61609","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23460","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with bone block","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19281","name":"Perq device breast 1st imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68510","name":"Biopsy of tear gland","description":"Biopsy of lacrimal gland","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95886","name":"Musc test done w/n test comp","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0413","name":"Pelvic ring fracture uni/bil","description":"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23412","name":"Repair rotator cuff chronic","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92579","name":"Visual audiometry (vra)","description":"Visual reinforcement audiometry (vra)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37785","name":"Ligate/divide/excise vein","description":"Ligation, division, and/or excision of varicose vein cluster(s), 1 leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44300","name":"Open bowel to skin","description":"Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87477","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27165","name":"Incision/fixation of femur","description":"Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64640","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; other peripheral nerve or branch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94360","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27703","name":"Reconstruction ankle joint","description":"Arthroplasty, ankle; revision, total ankle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27520","name":"Treat kneecap fracture","description":"Closed treatment of patellar fracture, without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21116","name":"Injection jaw joint x-ray","description":"Injection procedure for temporomandibular joint arthrography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01850","name":"Anes vein f/arm wrst&hnd nos","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35306","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; each additional tibial or peroneal artery (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90815","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43351","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; thoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44151","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, without proctectomy; with continent ileostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1807.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0247","name":"Trans bench w/wo comm open","description":"Transfer bench for tub or toilet with or without commode opening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33289","name":"Tcat impl wrls p-art prs snr","description":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring, including deployment and calibration of the sensor, right heart catheterization, selective pulmonary catheterization, radiological supervision and interpretation, and pulmonary artery angiog","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76506","name":"Echo exam of head","description":"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95076","name":"Ingest challenge ini 120 min","description":"Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance); initial 120 minutes of testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28341","name":"Resect enlarged toe","description":"Reconstruction, toe, macrodactyly; requiring bone resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77055","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63285","name":"Bx/exc idrl imed lesn cervl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2405.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4158.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31781","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervicothoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20802","name":"Replantation arm complete","description":"Replantation, arm (includes surgical neck of humerus through elbow joint), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2335.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42700","name":"I&d abscess peritonsillar","description":"Incision and drainage abscess; peritonsillar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44111","name":"Excision of bowel lesion(s)","description":"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82540","name":"Assay of creatine","description":"Creatine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93893","name":"Tcd std icr art ven-art shnt","description":"Transcranial doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99282","name":"Emergency dept visit sf mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82488","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21198","name":"Reconstr lwr jaw segment","description":"Osteotomy, mandible, segmental;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44388","name":"Colonoscopy thru stoma spx","description":"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","53"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69020","name":"Drg xtrnl aud canal abscess","description":"Drainage external auditory canal, abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54130","name":"Remove penis & nodes","description":"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27347","name":"Remove knee cyst","description":"Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50840","name":"Replace ureter by bowel","description":"Replacement of all or part of ureter by intestine segment, including intestine anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82103","name":"Alpha-1-antitrypsin total","description":"Alpha-1-antitrypsin; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26862","name":"Fusion/graft of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52260","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81204","name":"Ar gene charac alleles","description":"Ar (androgen receptor) (eg, spinal and bulbar muscular atrophy, kennedy disease, x chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72127","name":"Ct neck spine w/o & w/dye","description":"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27641","name":"Partial removal of fibula","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87172","name":"Pinworm exam","description":"Pinworm exam (eg, cellophane tape prep)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6296.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80420","name":"Dexamethasone panel","description":"Dexamethasone suppression panel, 48 hour this panel must include the following: free cortisol, urine (82530 x 2) cortisol (82533 x 2) volume measurement for timed collection (81050 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6014","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":55.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89330","name":"Evaluation cervical mucus","description":"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43425","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; transthoracic or transabdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93457","name":"R hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31629","name":"Bronchoscopy/needle bx each","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43843","name":"Gstr rstcv oth/thn v-band","description":"Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1075.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78453","name":"Ht muscle image planar sing","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97002","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4634.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2017.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87900","name":"Phenotype infect agent drug","description":"Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","name":"Anes maj lwr adb vsl ivc lig","description":"Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33366","name":"Trcath replace aortic valve","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; transapical exposure (eg, left thoracotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1373.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50240","name":"Nephrectomy partial","description":"Nephrectomy, partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50574","name":"Kidney endoscopy & biopsy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65150","name":"Revise ocular implant","description":"Reinsertion of ocular implant; with or without conjunctival graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71023","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47533","name":"Plmt biliary drainage cath","description":"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15789","name":"Chemical peel facial dermal","description":"Chemical peel, facial; dermal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1649.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56700","name":"Prtl hymnctmy/revj hymnl rng","description":"Partial hymenectomy or revision of hymenal ring","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25405","name":"Repair/graft radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67875","name":"Closure of eyelid by suture","description":"Temporary closure of eyelids by suture (eg, frost suture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86804","name":"Hep c ab test confirm","description":"Hepatitis c antibody; confirmatory test (eg, immunoblot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32671","name":"Thoracoscopy pneumonectomy","description":"Thoracoscopy, surgical; with removal of lung (pneumonectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1423.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37188","name":"Ven mechnl thrmbc repeat tx","description":"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during course of thrombolytic therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":813.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51610","name":"Injection for bladder x-ray","description":"Injection procedure for retrograde urethrocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15630","name":"Delay flap eye/nos/ear/lip","description":"Delay of flap or sectioning of flap (division and inset); at eyelids, nose, ears, or lips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14061","name":"Tis trnfr e/n/e/l10.1-30sqcm","description":"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28289","name":"Corrj halux rigdus w/o implt","description":"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68335","name":"Revise/graft eyelid lining","description":"Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93299","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95954","name":"Eeg monitoring/giving drugs","description":"Pharmacological or physical activation requiring physician or other qualified health care professional attendance during eeg recording of activation phase (eg, thiopental activation test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24120","name":"Exc/crtg b1 cst/b9 tum rds","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90997","name":"Hemoperfusion","description":"Hemoperfusion (eg, with activated charcoal or resin)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86744","name":"Nocardia antibody","description":"Antibody; nocardia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4565.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86310","name":"Heterophile antibody absrbj","description":"Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61710","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1972.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3268.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95079","name":"Ingest challenge addl 60 min","description":"Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance); each additional 60 minutes of testing (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61107","name":"Tdh pnxr implt ventr cath","description":"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78473","name":"Gated heart multiple","description":"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0337","name":"Hospice evaluation preelecti","description":"Hospice evaluation and counseling services, pre-election","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83630","name":"Lactoferrin fecal (qual)","description":"Lactoferrin, fecal; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93235","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48145","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87430","name":"Strep a ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; streptococcus, group a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27280","name":"Arthr si jt opn b1grf instrm","description":"Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1186.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37145","name":"Revision of circulation","description":"Venous anastomosis, open; renoportal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1895.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36014","name":"Place catheter in artery","description":"Selective catheter placement, left or right pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92273","name":"Full field erg w/i&r","description":"Electroretinography (erg), with interpretation and report; full field (ie, fferg, flash erg, ganzfeld erg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83033","name":"Hemoglobin ftl f assay qual","description":"Hemoglobin; f (fetal), qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66130","name":"Remove eye lesion","description":"Excision of lesion, sclera","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33944","name":"Prepare donor heart","description":"Backbench standard preparation of cadaver donor heart allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, pulmonary artery, and left atrium for implantation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0290","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1840.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95922","name":"Autonomic nrv adrenrg inervj","description":"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","name":"Anes hrna rpr<37wk brth<50","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32657","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2062","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27704","name":"Removal of ankle implant","description":"Removal of ankle implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21100","name":"Maxillofacial fixation","description":"Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75996","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0516","name":"Insert drug del implant, >=4","description":"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":14.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60500","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25425","name":"Repair/graft radius or ulna","description":"Repair of defect with autograft; radius or ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19284","name":"Perq dev breast add strtctc","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including stereotactic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50526","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1384.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27333","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial and lateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4333.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95723","name":"Eeg phy/qhp>60<84 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 60 hours, up to 84 hours of eeg recording, without video","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21742","name":"Repair stern/nuss w/o scope","description":"Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (nuss procedure), without thoracoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97750","name":"Physical performance test","description":"Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51880","name":"Repair of bladder opening","description":"Closure of cystostomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00528","name":"Anes clsd ch mediast&thrc wo","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35800","name":"Explore neck vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43197","name":"Esophagoscopy flex dx brush","description":"Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63076","name":"Neck spine disk surgery","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67973","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33511","name":"Cabg vein two","description":"Coronary artery bypass, vein only; 2 coronary venous grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1846.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61623","name":"Evasc temp balo artl occ h/n","description":"Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon, concomitant neurological monitoring, and radiologic supervision and interpretation of all angiogra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93284","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous impla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24500","name":"Cltx humrl shft fx w/o mnpj","description":"Closed treatment of humeral shaft fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2848.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93455","name":"Coronary art/grft angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71023","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77001","name":"Fluoroguide for vein device","description":"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic su","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61522","name":"Removal of brain abscess","description":"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2006.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77768","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27060","name":"Removal of ischial bursa","description":"Excision; ischial bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46600","name":"Diagnostic anoscopy spx","description":"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85366","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); paracoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20527","name":"Njx nzm palmar fascial cord","description":"Injection, enzyme (eg, collagenase), palmar fascial cord (ie, dupuytrens contracture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94070","name":"Evaluation of wheezing","description":"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78483","name":"Heart first pass multiple","description":"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1685.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25105","name":"Remove wrist joint lining","description":"Arthrotomy, wrist joint; with synovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22505","name":"Manipulation of spine","description":"Manipulation of spine requiring anesthesia, any region","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49465","name":"Fluoro exam of g/colon tube","description":"Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92242","name":"Fluorescein&icg angiography","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4087","name":"Gastro/jejuno tube, std","description":"Gastrostomy/jejunostomy tube, standard, any material, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31231","name":"Nasal endoscopy dx","description":"Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21461","name":"Optx mndblr fx wo ntrdntl","description":"Open treatment of mandibular fracture; without interdental fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1634.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1815","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82664","name":"Electrophoretic test","description":"Electrophoretic technique, not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0481","name":"Intrpulmnry percuss vent sys","description":"Intrapulmonary percussive ventilation system and related accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11755.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","name":"Anes open px lower l/a/f nos","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP19","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48120","name":"Removal of pancreas lesion","description":"Excision of lesion of pancreas (eg, cyst, adenoma)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93454","name":"Coronary artery angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86687","name":"Htlv-i antibody","description":"Antibody; htlv-i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96159","name":"Hlth bhv ivntj indiv ea addl","description":"Health behavior intervention, individual, face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1429.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44005","name":"Freeing of bowel adhesion","description":"Enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89321","name":"Semen anal sperm detection","description":"Semen analysis; sperm presence and motility of sperm, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74248","name":"X-ray sm int f-thru std","description":"Radiologic small intestine follow-through study, including multiple serial images (list separately in addition to code for primary procedure for upper gi radiologic examination)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0442","name":"Annual alcohol screen 15 min","description":"Annual alcohol misuse screening, 5 to 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75562","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20933","name":"Hemicrt intrclry algrft prtl","description":"Allograft, includes templating, cutting, placement and internal fixation, when performed; hemicortical intercalary, partial (ie, hemicylindrical) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","name":"Anes opn rpr fx disrpj plvs","description":"Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","name":"Anes th ivnt rad ntrthrc/jug","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50435","name":"Exchange nephrostomy cath","description":"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A4365","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87550","name":"Mycobacteria dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93325","name":"Doppler echo color flow mapg","description":"Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67966","name":"Revision of eyelid","description":"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; over one-fourth of lid margin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52204","name":"Cystoscopy w/biopsy(s)","description":"Cystourethroscopy, with biopsy(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94002","name":"Vent mgmt inpat init day","description":"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81420","name":"Fetal chrmoml aneuploidy","description":"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy x) genomic sequence analysis panel, circulating cell-free fetal dna in maternal blood, must include analysis of chromosomes 13, 18, and 21","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2534.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83890","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7178.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44130","name":"Bowel to bowel fusion","description":"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83498","name":"Asy hydroxyprogesterone 17-d","description":"Hydroxyprogesterone, 17-d","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86694","name":"Herpes simplex nes antbdy","description":"Antibody; herpes simplex, non-specific type test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1918.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59320","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; vaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66852","name":"Removal of lens material","description":"Removal of lens material; pars plana approach, with or without vitrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35537","name":"Art byp grft aortoiliac","description":"Bypass graft, with vein; aortoiliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42808","name":"Excise pharynx lesion","description":"Excision or destruction of lesion of pharynx, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61607","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2313.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28289","name":"Corrj halux rigdus w/o implt","description":"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97002","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92547","name":"Supplemental electrical test","description":"Use of vertical electrodes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35341","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, or renal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1211.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84233","name":"Assay of estrogen","description":"Receptor assay; estrogen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62121","name":"Incise skull repair","description":"Craniotomy for repair of encephalocele, skull base","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1338.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85705","name":"Thromboplastin inhibition","description":"Thromboplastin inhibition, tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31574","name":"Largsc w/njx augmentation","description":"Laryngoscopy, flexible; with injection(s) for augmentation (eg, percutaneous, transoral), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01953","name":"Anes 2&3 burn ea add 9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; each additional 9% total body surface area or part thereof (list separately in addition to code for primary procedur","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1499.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86310","name":"Heterophile antibody absrbj","description":"Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63300","name":"Remove vert xdrl body crvcl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1658.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5330.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2335.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9985","name":"Remote e/m est. pt 25mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a detailed history; a detailed exami","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86860","name":"Rbc antibody elution","description":"Antibody elution (rbc), each elution","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88388","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"Esrd home pt serv p mo 2-11","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35905","name":"Excision graft thorax","description":"Excision of infected graft; thorax","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1553.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93642","name":"Ep evl 1/2chmb trnsvns cvdfb","description":"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parame","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84060","name":"Assay acid phosphatase","description":"Phosphatase, acid; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1514.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0441","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73542","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20694","name":"Rmvl ext fixj sys under anes","description":"Removal, under anesthesia, of external fixation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27825","name":"Treat lower leg fracture","description":"Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; with skeletal traction and/or requiring manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27788","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82127","name":"Amino acid single qual","description":"Amino acids; single, qualitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56620","name":"Vulvectomy simple partial","description":"Vulvectomy simple; partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19101","name":"Biopsy of breast open","description":"Biopsy of breast; open, incisional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96422","name":"Chemo ia infusion up to 1 hr","description":"Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["AU","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23900","name":"Interthoracoscplr amputation","description":"Interthoracoscapular amputation (forequarter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43326","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":988.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27479","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); combined distal femur, proximal tibia and fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86695","name":"Herpes simplex type 1 test","description":"Antibody; herpes simplex, type 1","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2847.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33963","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35521","name":"Art byp grft axill-femoral","description":"Bypass graft, with vein; axillary-femoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1082.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27105","name":"Transfer of spinal muscle","description":"Transfer paraspinal muscle to hip (includes fascial or tendon extension graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83864","name":"Mucopolysaccharides","description":"Mucopolysaccharides, acid, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27538","name":"Treat knee fracture(s)","description":"Closed treatment of intercondylar spine(s) and/or tuberosity fracture(s) of knee, with or without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41019","name":"Place needles h&n for rt","description":"Placement of needles, catheters, or other device(s) into the head and/or neck region (percutaneous, transoral, or transnasal) for subsequent interstitial radioelement application","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":343.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3733.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30020","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal septum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64864","name":"Repair of facial nerve","description":"Suture of facial nerve; extracranial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68720","name":"Create tear sac drain","description":"Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565T","name":"Autol cell implt adps hrvg","description":"Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; tissue harvesting and cellular implant creation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82383","name":"Assay blood catecholamines","description":"Catecholamines; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99448","name":"Ntrprof ph1/ntrnet/ehr 21-30","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","name":"Anes iper upr abd pncrtect","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, whipple procedure)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29720","name":"Repair spica body cst/jacket","description":"Repair of spica, body cast or jacket","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36573","name":"Insj picc rs&i 5 yr+","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; age 5 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31086","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74251","name":"X-ray xm sm int 2cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45540","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65770","name":"Keratoprosthesis","description":"Keratoprosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74283","name":"Ther nma rdctj intus/obstrcj","description":"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93784","name":"Ambl bp mntr w/software","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; including recording, scanning analysis, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33967","name":"Insert i-aort percut device","description":"Insertion of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33015","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":457.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25560","name":"Cltx rdl&uln shft fx wo mnpj","description":"Closed treatment of radial and ulnar shaft fractures; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64420","name":"Njx aa&/strd ntrcost nrv 1","description":"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73721","name":"Mri jnt of lwr extre w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33463","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; without ring insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2676.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81414","name":"Car ion chnnlpath inc 2 gns","description":"Cardiac ion channelopathies (eg, brugada syndrome, long qt syndrome, short qt syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include analysis of at least 2 genes, including kcnh2 and kcnq1","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15100","name":"Splt agrft t/a/l 1st 100sqcm","description":"Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88165","name":"Cytopath tbs c/v redo","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92576","name":"Synthetic sentence id test","description":"Synthetic sentence identification test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80047","name":"Basic metablc pnl ionized ca","description":"Basic metabolic panel (calcium, ionized) this panel must include the following: calcium, ionized (82330) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52332","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, gibbons or double-j type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87480","name":"Candida dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54352","name":"Revj prior hypspad repair","description":"Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of local skin as grafts and island flaps and skin brought in as flaps or grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1146.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64895","name":"Nrv grf mltst hnd/foot <4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28020","name":"Exploration of foot joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26580","name":"Repair cleft hand","description":"Repair cleft hand","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47350","name":"Repair liver wound","description":"Management of liver hemorrhage; simple suture of liver wound or injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5225.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87563","name":"M. genitalium amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma genitalium, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67311","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 horizontal muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85540","name":"Wbc alkaline phosphatase","description":"Leukocyte alkaline phosphatase with count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2087","name":"Off base opioid tx, 60 m","description":"Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59300","name":"Episiotomy or vaginal repair","description":"Episiotomy or vaginal repair, by other than attending","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26020","name":"Drain hand tendon sheath","description":"Drainage of tendon sheath, digit and/or palm, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93893","name":"Tcd std icr art ven-art shnt","description":"Transcranial doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33422","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; open heart, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4189","name":"Parenteral sol amino acid &","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84133","name":"Assay of urine potassium","description":"Potassium; urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57296","name":"Revise vag graft open abd","description":"Revision (including removal) of prosthetic vaginal graft; open abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55815","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96111","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46716","name":"Rep perf anoper/vestib fistu","description":"Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26545","name":"Reconstruct finger joint","description":"Reconstruction, collateral ligament, interphalangeal joint, single, including graft, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","name":"Anes px art knee&pop teaec","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33234","name":"Removal of pacemaker system","description":"Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51040","name":"Incise & drain bladder","description":"Cystostomy, cystotomy with drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21811","name":"Optx of rib fx w/fixj scope","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 1-3 ribs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27830","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61340","name":"Subtemporal cranial dcmprn","description":"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1314.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32659","name":"Thoracoscopy w/sac drainage","description":"Thoracoscopy, surgical; with creation of pericardial window or partial resection of pericardial sac for drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2061","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"Psytx w pt 60 minutes","description":"Psychotherapy, 60 minutes with patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71552","name":"Mri chest w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40720","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60240","name":"Removal of thyroid","description":"Thyroidectomy, total or complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62180","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy (torkildsen type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1461.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31640","name":"Bronchoscopy w/tumor excise","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69205","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; with general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11107","name":"Incal bx skn ea sep/addl","description":"Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); each separate/additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86593","name":"Syphilis test non-trep quant","description":"Syphilis test, non-treponemal antibody; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":188.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26565","name":"Correct metacarpal flaw","description":"Osteotomy; metacarpal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48102","name":"Needle biopsy pancreas","description":"Biopsy of pancreas, percutaneous needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23500","name":"Cltx clavicular fx w/o mnpj","description":"Closed treatment of clavicular fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27511","name":"Treatment of thigh fracture","description":"Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21082","name":"Impres&prep paltl aug prosth","description":"Impression and custom preparation; palatal augmentation prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22558","name":"Arthrd ant ntrbd min dsc lum","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1339.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47605","name":"Cholecystectomy w/cholang","description":"Cholecystectomy; with cholangiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":939.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0150T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78429","name":"Myocrd img pet 1 std w/ct","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93306","name":"Tte w/doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63020","name":"Lamot dcmprn nrv rt 1 cerv","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1027.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72158","name":"Mri lumbar spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86304","name":"Immunoassay tumor ca 125","description":"Immunoassay for tumor antigen, quantitative; ca 125","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27369","name":"Njx cntrst kne arthg/ct/mri","description":"Injection procedure for contrast knee arthrography or contrast enhanced ct/mri knee arthrography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0420","name":"Ed svc ckd ind per session","description":"Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15155","name":"Tis cltr agrft f/s/n/h/f/g 1","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67220","name":"Treatment of choroid lesion","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22812","name":"Arthrd ant dfrm 8+ vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1876.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33249","name":"Insj/rplcmt defib w/lead(s)","description":"Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11423","name":"Exc h-f-nk-sp b9+marg 2.1-3","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45121","name":"Removal of rectum and colon","description":"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with subtotal or total colectomy, with multiple biopsies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1462.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86256","name":"Fluorescent antibody titer","description":"Fluorescent noninfectious agent antibody; titer, each antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27137","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47760","name":"Fuse bile ducts and bowel","description":"Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1883.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35021","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, innominate, subclavian artery, by thoracic incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22326","name":"Treat neck spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1338.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86161","name":"Complement/function activity","description":"Complement; functional activity, each component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25120","name":"Removal of forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55862","name":"Extensive prostate surgery","description":"Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20200","name":"Muscle biopsy superficial","description":"Biopsy, muscle; superficial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93619","name":"Comprehensive ep evaluation","description":"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57220","name":"Revision of urethra","description":"Plastic operation on urethral sphincter, vaginal approach (eg, kelly urethral plication)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36905","name":"Thrmbc/nfs dialysis circuit","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thromboly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68801.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45100","name":"Biopsy of rectum","description":"Biopsy of anorectal wall, anal approach (eg, congenital megacolon)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35587","name":"Vein byp pop-tibl peroneal","description":"In-situ vein bypass; popliteal-tibial, peroneal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","name":"Anes upr gi ndsc px nos","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93320","name":"Doppler echo complete","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69637","name":"Rebuild eardrum structures","description":"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [porp], total ossicular replacement prosthesis [torp])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0444","name":"Depression screen annual","description":"Annual depression screening, 5 to 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25574","name":"Optx rdl&uln shft fx rds/uln","description":"Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius or ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43361","name":"Gastrointestinal repair","description":"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","KM","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55500","name":"Removal of hydrocele","description":"Excision of hydrocele of spermatic cord, unilateral (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10035","name":"Plmt sft tiss loclzj dev 1st","description":"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3419.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95081.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33261","name":"Ablate heart dysrhythm focus","description":"Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43887","name":"Gstr rstcv px opn rmvl port","description":"Gastric restrictive procedure, open; removal of subcutaneous port component only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27177","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; single or multiple pinning or bone graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16030","name":"Dress/debrid p-thick burn l","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33521","name":"Cabg artery-vein four","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 4 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43271","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21343","name":"Open tx dprsd front sinus fx","description":"Open treatment of depressed frontal sinus fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83937","name":"Assay of osteocalcin","description":"Osteocalcin (bone g1a protein)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27810","name":"Treatment of ankle fracture","description":"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92610","name":"Evaluate swallowing function","description":"Evaluation of oral and pharyngeal swallowing function","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92518","name":"Vemp test i&r ocular","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; ocular (ovemp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67340","name":"Revise eye muscle add-on","description":"Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54430","name":"Revision of penis","description":"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35207","name":"Rpr bld vsl dir hand finger","description":"Repair blood vessel, direct; hand, finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66160","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54340","name":"Rpr hypspad comp simple","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1991.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25606","name":"Perq skel fixj dstl rdl fx","description":"Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54800","name":"Biopsy of epididymis","description":"Biopsy of epididymis, needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35721","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45321","name":"Proctosigmoidoscopy volvul","description":"Proctosigmoidoscopy, rigid; with decompression of volvulus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31820","name":"Closure of windpipe lesion","description":"Surgical closure tracheostomy or fistula; without plastic repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95836","name":"Ecog impltd brn npgt <30 d","description":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter, including recording, with interpretation and written report, up to 30 days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27472","name":"Repair/graft of thigh","description":"Repair, nonunion or malunion, femur, distal to head and neck; with iliac or other autogenous bone graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92984","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63185","name":"Incise spine nrv half segmnt","description":"Laminectomy with rhizotomy; 1 or 2 segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61105","name":"Tdh sdrl/ventr pnxr","description":"Twist drill hole for subdural or ventricular puncture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23406","name":"Incise tendon(s) & muscle(s)","description":"Tenotomy, shoulder area; multiple tendons through same incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45385","name":"Colonoscopy w/lesion removal","description":"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24140","name":"Partial exc bone humerus","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24920","name":"Amputation of upper arm","description":"Amputation, arm through humerus; open, circular (guillotine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43846","name":"Gstr rstcv px shrt roux-en-y","description":"Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) roux-en-y gastroenterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66920","name":"Extraction of lens","description":"Removal of lens material; intracapsular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86870","name":"Rbc antibody identification","description":"Antibody identification, rbc antibodies, each panel for each serum technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31085","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2055.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42700","name":"I&d abscess peritonsillar","description":"Incision and drainage abscess; peritonsillar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87277","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0147T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51900","name":"Repair bladder/vagina lesion","description":"Closure of vesicovaginal fistula, abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28630","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54220","name":"Irrg crpra cavrnosa priapism","description":"Irrigation of corpora cavernosa for priapism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83050","name":"Hgb methemoglobin quan","description":"Hemoglobin; methemoglobin, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99152","name":"Mod sed same phys/qhp 5/>yrs","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42892","name":"Revision of pharyngeal walls","description":"Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65222","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, with slit lamp","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31290","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21933","name":"Exc back tum deep 5 cm/>","description":"Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1860.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35111","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, splenic artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92083","name":"Extended visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, hump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82140","name":"Assay of ammonia","description":"Ammonia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82340","name":"Assay of calcium in urine","description":"Calcium; urine quantitative, timed specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64763","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62010","name":"Treatment of head injury","description":"Elevation of depressed skull fracture; with repair of dura and/or debridement of brain","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87634","name":"Rsv dna/rna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); respiratory syncytial virus, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82728","name":"Assay of ferritin","description":"Ferritin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82145","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9486","name":"Remote e/m est. pt 10mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward med","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23412","name":"Repair rotator cuff chronic","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2848.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41512","name":"Tongue suspension","description":"Tongue base suspension, permanent suture technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92610","name":"Evaluate swallowing function","description":"Evaluation of oral and pharyngeal swallowing function","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","name":"Anes px heart w/o pump oxtj","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31601","name":"Planned tracheostomy<2 yrs","description":"Tracheostomy, planned (separate procedure); younger than 2 years","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2335.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4215","name":"Sterile needle","description":"Needle, sterile, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42310","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary or sublingual, intraoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99368","name":"Team conf w/o pat by hc pro","description":"Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by nonphysician qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86486","name":"Skin test unlisted antign ea","description":"Skin test; unlisted antigen, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32440","name":"Remove lung pneumonectomy","description":"Removal of lung, pneumonectomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5199.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"Patient recorded spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; recording (includes hook-up, reinforced education, data transmission, data capture, trend analysis, and periodic recalibration)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19286","name":"Perq dev breast add us imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including ultrasound guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86386","name":"Nuclear matrix protein 22","description":"Nuclear matrix protein 22 (nmp22), qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93289","name":"Interrog device eval heart","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including anal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27495","name":"Reinforce thigh","description":"Prophylactic treatment (nailing, pinning, plating, or wiring) with or without methylmethacrylate, femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35184","name":"Rpr cgen av fistula xtr","description":"Repair, congenital arteriovenous fistula; extremities","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66150","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trephination with iridectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27078","name":"Rsect hip tum incl femur","description":"Radical resection of tumor; ischial tuberosity and greater trochanter of femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82960","name":"Test for g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":470.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2657.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50045","name":"Nephrotomy w/exploration","description":"Nephrotomy, with exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93631","name":"Ntraop epicar&endcar pac&map","description":"Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87550","name":"Mycobacteria dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69801","name":"Incise inner ear","description":"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","name":"Anes integumentary sys nos","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49657","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0145T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85730","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); plasma or whole blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50543","name":"Laparo partial nephrectomy","description":"Laparoscopy, surgical; partial nephrectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76377","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22808","name":"Arthrd ant dfrm 2-3 vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1614.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61210","name":"Burr hole implt ventr cath","description":"Burr hole(s); for implanting ventricular catheter, reservoir, eeg electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93981","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00792","name":"Anes iper upr abd prtl hptc","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; partial hepatectomy or management of liver hemorrhage (excluding liver biopsy)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96374","name":"Ther/proph/diag inj iv push","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28430","name":"Cltx talus fracture w/o mnpj","description":"Closed treatment of talus fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22522","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52351","name":"Cystouretero & or pyeloscope","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20611","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95904","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5103.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49060","name":"Drain open retroperi abscess","description":"Drainage of retroperitoneal abscess, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31291","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; sphenoid region","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67973","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69646","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93271","name":"Ecg/monitoring and analysis","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; transmission and analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0281","name":"Elec stim unattend for press","description":"Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82979","name":"Assay rbc glutathione","description":"Glutathione reductase, rbc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28530","name":"Treat sesamoid bone fracture","description":"Closed treatment of sesamoid fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75993","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35646","name":"Bpg aortobifemoral","description":"Bypass graft, with other than vein; aortobifemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1511.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87071","name":"Culture aerobic quant other","description":"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93287","name":"Peri-px device eval & prgr","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","name":"Anes opn lwr l/a/f rad rescj","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","name":"Anes xtnsv sp&spi cord px","description":"Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20701","name":"Rmvl deep rx delivery device","description":"Removal of drug-delivery device(s), deep (eg, subfascial) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33610","name":"Repair by enlargement","description":"Repair of complex cardiac anomalies (eg, single ventricle with subaortic obstruction) by surgical enlargement of ventricular septal defect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80173","name":"Assay of haloperidol","description":"Haloperidol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83491","name":"Asy hydroxycorticosteroids17","description":"Hydroxycorticosteroids, 17- (17-ohcs)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50387","name":"Change nephroureteral cath","description":"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3822.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25652","name":"Optx ulnar styloid fracture","description":"Open treatment of ulnar styloid fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43257","name":"Egd w/thrml txmnt gerd","description":"Esophagogastroduodenoscopy, flexible, transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6200","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35881","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with segmental vein interposition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":899.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82376","name":"Assay carboxyhb qual","description":"Carboxyhemoglobin; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87640","name":"Staph a dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); staphylococcus aureus, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","name":"Anes 2&3 burn 4-9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; between 4% and 9% of total body surface area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49426","name":"Revise abdomen-venous shunt","description":"Revision of peritoneal-venous shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63271","name":"Excise intrspinl lesion thrc","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1890.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82172","name":"Assay of apolipoprotein","description":"Apolipoprotein, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0413","name":"Pelvic ring fracture uni/bil","description":"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15620","name":"Delay flap f/c/c/n/ax/g/h/f","description":"Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64858","name":"Repair sciatic nerve","description":"Suture of sciatic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14021","name":"Tis trnfr s/a/l 10.1-30 sqcm","description":"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25295","name":"Release wrist/forearm tendon","description":"Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27825","name":"Treat lower leg fracture","description":"Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; with skeletal traction and/or requiring manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23530","name":"Optx strnclav dislc aqt/chrn","description":"Open treatment of sternoclavicular dislocation, acute or chronic;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3503.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93018","name":"Cv stress test i&r only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1976.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46917","name":"Laser surgery anal lesions","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96000","name":"Motion analysis video/3d","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90912","name":"Bfb training 1st 15 min","description":"Biofeedback training, perineal muscles, anorectal or urethral sphincter, including emg and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74175","name":"Cta abdomen w/contrast","description":"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1748.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37607","name":"Lig/banding angioacs av fstl","description":"Ligation or banding of angioaccess arteriovenous fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62310","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34806","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21150","name":"Rcnstj mdfc lefrtii ant ntru","description":"Reconstruction midface, lefort ii; anterior intrusion (eg, treacher-collins syndrome)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1344.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30462","name":"Revision of nose","description":"Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip, septum, osteotomies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27648","name":"Injection for ankle x-ray","description":"Injection procedure for ankle arthrography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69605","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82642","name":"Dihydrotestosterone","description":"Dihydrotestosterone (dht)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73720","name":"Mri lwr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2295.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0434","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74240","name":"X-ray xm upr gi trc 1cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86654","name":"Encephaltis west eqne antbdy","description":"Antibody; encephalitis, western equine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01272","name":"Anes px art femoral art lig","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery ligation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78227","name":"Hepatobil syst image w/drug","description":"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"Init pm e/m new pat infant","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age youn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27370","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43496","name":"Free jejunum flap microvasc","description":"Free jejunum transfer with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"Demo&/eval pt use inhaler","description":"Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or ippb device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87188","name":"Sc std macrobroth dil meth","description":"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61514","name":"Crnec treph exc brn abs sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1744.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46045","name":"I&d absc tranal under anes","description":"Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43641","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53661","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31367","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, without radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1642.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"Home/res vst est mod mdm 40","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or excee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33270","name":"Ins/rep subq defibrillator","description":"Insertion or replacement of permanent subcutaneous implantable defibrillator system, with subcutaneous electrode, including defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic param","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15935","name":"Exc sac pr ulc skn flp ostc","description":"Excision, sacral pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93893","name":"Tcd std icr art ven-art shnt","description":"Transcranial doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86756","name":"Respiratory virus antibody","description":"Antibody; respiratory syncytial virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4150","name":"Ef complet w/intact nutrient","description":"Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83497","name":"Assay of 5-hiaa","description":"Hydroxyindolacetic acid, 5-(hiaa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3384.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["AW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33779","name":"Rpr tga rcnstj rmvl plm bnd","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with removal of pulmonary band","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87632","name":"Resp virus 6-11 targets","description":"Infectious agent detection by nucleic acid (dna or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21012","name":"Exc face les sbq 2 cm/>","description":"Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20205","name":"Deep muscle biopsy","description":"Biopsy, muscle; deep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33141","name":"Heart tmr w/other procedure","description":"Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61868","name":"Implant neuroelectrde addl","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; each additional ar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","name":"Anes all px nrv msc kne&/pop","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41150","name":"Tongue mouth jaw surgery","description":"Glossectomy; composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33474","name":"Revision of pulmonary valve","description":"Valvotomy, pulmonary valve, open heart, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1894.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77003","name":"Fluoroguide for spine inject","description":"Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22212","name":"Incis 1 vertebral seg thorac","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0433","name":"Elisa hiv-1/hiv-2 screen","description":"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28725","name":"Arthrodesis subtalar","description":"Arthrodesis; subtalar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63085","name":"Remove vert body dcmprn thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1709.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0398","name":"Home sleep test/type 2 porta","description":"Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88305","name":"Tissue exam by pathologist","description":"Level iv - surgical pathology, gross and microscopic examination abortion - spontaneous/missed artery, biopsy bone marrow, biopsy bone exostosis brain/meninges, other than for tumor resection breast, biopsy, not requiring microscopic evaluation of surgical margins breast, reduction mammoplasty bronc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93293","name":"Pm phone r-strip device eval","description":"Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26080","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92924","name":"Prq trluml c athrc 1 art&/br","description":"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4176","name":"Parenteral sol amino acid 7-","description":"Parenteral nutrition solution; amino acid, 7% through 8.5%, (500 ml = 1 unit) - home mix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29705","name":"Rmvl/bivlv full arm/leg cast","description":"Removal or bivalving; full arm or full leg cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84220","name":"Assay of pyruvate kinase","description":"Pyruvate kinase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97605","name":"Neg prs wnd ther dme<=50sqcm","description":"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (dme), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50432","name":"Plmt nephrostomy catheter","description":"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1712.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15002","name":"Wound prep trk/arm/leg","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78496","name":"Heart first pass add-on","description":"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84560","name":"Assay of urine/uric acid","description":"Uric acid; other source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75978","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88331","name":"Path consltj surg 1 blk 1spc","description":"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76936","name":"Echo guide for artery repair","description":"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82553","name":"Creatine mb fraction","description":"Creatine kinase (ck), (cpk); mb fraction only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58950","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49204","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74210","name":"X-ray xm phrnx&/crv esoph c+","description":"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78596","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75791","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86902","name":"Blood type antigen donor ea","description":"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","name":"Anes upr lwr gi ndsc px","description":"Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31075","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, lynch type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22856","name":"Tot disc arthrp 1ntrspc crv","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0222","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73202","name":"Ct uppr extremity w/o&w/dye","description":"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27536","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); bicondylar, with or without internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83864","name":"Mucopolysaccharides","description":"Mucopolysaccharides, acid, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5362","name":"Speech screening","description":"Speech screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4209","name":"5+ cc sterile syringe&needle","description":"Syringe with needle, sterile 5 cc or greater, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77083","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22802","name":"Arthrd pst dfrm 7-12 vrt sgm","description":"Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1837.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88153","name":"Cytopath c/v redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","name":"Anes gastrocnemius recession","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01810","name":"Anes px nrv musc f/arm wrst","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26236","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41826","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57555","name":"Remove cervix/repair vagina","description":"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21044","name":"Removal of jaw bone lesion","description":"Excision of malignant tumor of mandible;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88233","name":"Tissue culture skin/biopsy","description":"Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84244","name":"Assay of renin","description":"Renin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65114","name":"Remove eye/revise socket","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":923.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97164","name":"Pt re-eval est plan care","description":"Re-evaluation of physical therapy established plan of care, requiring these components: an examination including a review of history and use of standardized tests and measures is required; and revised plan of care using a standardized patient assessment instrument and/or measurable assessment of fun","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54692","name":"Laparoscopy orchiopexy","description":"Laparoscopy, surgical; orchiopexy for intra-abdominal testis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27248","name":"Treat thigh fracture","description":"Open treatment of greater trochanteric fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4730","name":"Fistula cannulation set, ea","description":"Fistula cannulation set for hemodialysis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35216","name":"Rpr blvsl dir ntrthrc wo byp","description":"Repair blood vessel, direct; intrathoracic, without bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1799.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84202","name":"Assay rbc protoporphyrin","description":"Protoporphyrin, rbc; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19100","name":"Bx breast percut w/o image","description":"Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27238","name":"Treat thigh fracture","description":"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3265.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66030","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); medication","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87168","name":"Macroscopic exam arthropod","description":"Macroscopic examination; arthropod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22854","name":"Insj biomechanical device","description":"Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrod","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61596","name":"Transcochlear approach/skull","description":"Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1991.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12046","name":"Intmd rpr n-hf/genit20.1-30","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 20.1 cm to 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33322","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58673","name":"Laparoscopy salpingostomy","description":"Laparoscopy, surgical; with salpingostomy (salpingoneostomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21335","name":"Open tx nose & septal fx","description":"Open treatment of nasal fracture; with concomitant open treatment of fractured septum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42835","name":"Removal of adenoids","description":"Adenoidectomy, secondary; younger than age 12","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93284","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous impla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86831","name":"Hla class ii phenotype qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); antibody identification by qualitative panel using complete hla phenotypes, hla class ii","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1755.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6215","name":"Foam dressing wound filler","description":"Foam dressing, wound filler, sterile, per gram","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01936","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86774","name":"Tetanus antibody","description":"Antibody; tetanus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26340","name":"Manipulate finger w/anesth","description":"Manipulation, finger joint, under anesthesia, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52342","name":"Cysto w/up stricture tx","description":"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87492","name":"Chlmyd trach dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19380","name":"Revj reconstructed breast","description":"Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91312","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43118","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3028.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45392","name":"Colonoscopy w/endoscopic fnb","description":"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1982.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64742","name":"Incision of facial nerve","description":"Transection or avulsion of; facial nerve, differential or complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64425","name":"Njx aa&/strd ii ih nerves","description":"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2180.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29445","name":"Appl rigid tot cntc leg cast","description":"Application of rigid total contact leg cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44404","name":"Colonoscopy w/injection","description":"Colonoscopy through stoma; with directed submucosal injection(s), any substance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53852","name":"Prostatic rf thermotx","description":"Transurethral destruction of prostate tissue; by radiofrequency thermotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1219.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33600","name":"Closure of valve","description":"Closure of atrioventricular valve (mitral or tricuspid) by suture or patch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68810","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61150","name":"Bur hol/trph drg brn abs/cst","description":"Burr hole(s) or trephine; with drainage of brain abscess or cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1233.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54670","name":"Repair testis injury","description":"Suture or repair of testicular injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83518","name":"Immunoassay dipstick","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15572","name":"Skin pedicle flap arms/legs","description":"Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26516","name":"Fusion of knuckle joint","description":"Capsulodesis, metacarpophalangeal joint; single digit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4236.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19295","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":112.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33282","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25390","name":"Shorten radius or ulna","description":"Osteoplasty, radius or ulna; shortening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27137","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44380","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76937","name":"Us guide vascular access","description":"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86664","name":"Epstein-barr nuclear antigen","description":"Antibody; epstein-barr (eb) virus, nuclear antigen (ebna)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0083","name":"Care man h v ext pt 45 m","description":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75993","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33272","name":"Rmvl of subq defibrillator","description":"Removal of subcutaneous implantable defibrillator electrode","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88143","name":"Cytopath c/v thin layer redo","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93985","name":"Dup-scan hemo compl bi std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28286","name":"Repair of hammertoe","description":"Correction, cock-up fifth toe, with plastic skin closure (eg, ruiz-mora type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22305","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","name":"Anes 2&3 burn 4-9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; between 4% and 9% of total body surface area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73223","name":"Mri joint upr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92943","name":"Prq trluml revsc ch occ ant","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; antegrade","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72081","name":"X-ray exam entire spi 1 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27880","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9273","name":"Hot/cold botle/cap/col/wrap","description":"Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15321","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10004","name":"Fna bx w/o img gdn ea addl","description":"Fine needle aspiration biopsy, without imaging guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53448","name":"Remov/replc ur sphinctr comp","description":"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement of infected tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49084","name":"Peritoneal lavage","description":"Peritoneal lavage, including imaging guidance, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86360","name":"T cell absolute count/ratio","description":"T cells; absolute cd4 and cd8 count, including ratio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77083","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67924","name":"Repair eyelid defect","description":"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88280","name":"Chromosome karyotype study","description":"Chromosome analysis; additional karyotypes, each study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88239","name":"Tissue culture tumor","description":"Tissue culture for neoplastic disorders; solid tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9483","name":"Remote e/m new pt 30mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real tim","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01484","name":"Anes opn lw l/a/f oste/ostpl","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43274","name":"Ercp duct stent placement","description":"Endoscopic retrograde cholangiopancreatography (ercp); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92502","name":"Ear and throat examination","description":"Otolaryngologic examination under general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21076","name":"Impres&prep surg obt prosth","description":"Impression and custom preparation; surgical obturator prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2065.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":5097.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32100","name":"Exploration of chest","description":"Thoracotomy; with exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0886","name":"Pwc gp4 hd mult pow s/b","description":"Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30118","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; external approach (lateral rhinotomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":57.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28436","name":"Prq skel fix talus fx w/mnpj","description":"Percutaneous skeletal fixation of talus fracture, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94725","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17274","name":"Dstr mal les s/n/h/f/g 3.1-4","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78429","name":"Myocrd img pet 1 std w/ct","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2667.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22336.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27332","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial or lateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78586","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67835","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin, with free mucous membrane graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51728","name":"Cystometrogram w/vp","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82252","name":"Fecal bilirubin test","description":"Bilirubin; feces, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86592","name":"Syphilis test non-trep qual","description":"Syphilis test, non-treponemal antibody; qualitative (eg, vdrl, rpr, art)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4465","name":"Non-elastic extremity binder","description":"Non-elastic binder for extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27140","name":"Transplant femur ridge","description":"Osteotomy and transfer of greater trochanter of femur (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99607","name":"Mtms by pharm addl 15 min","description":"Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44384","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52346","name":"Cystouretero w/renal strict","description":"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36565","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; without subcutaneous port or pump (eg, tesio type catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77002","name":"Needle localization by xray","description":"Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35651","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1427.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52250","name":"Cystoscopy and radiotracer","description":"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74210","name":"X-ray xm phrnx&/crv esoph c+","description":"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99149","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78609","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); perfusion evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4306","name":"Drug delivery system <=50 ml","description":"Disposable drug delivery system, flow rate of less than 50 ml per hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2824.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61770","name":"Incise skull for treatment","description":"Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1484.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52300","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4673","name":"Ext line w easy lock connect","description":"Extension line with easy lock connectors, used with dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3103.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5225.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88263","name":"Chromosome analysis 45","description":"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76983","name":"Use ea addl target lesion","description":"Ultrasound, elastography; each additional target lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92020","name":"Gonioscopy","description":"Gonioscopy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33513","name":"Cabg vein four","description":"Coronary artery bypass, vein only; 4 coronary venous grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2157.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28234","name":"Incision of foot tendon","description":"Tenotomy, open, extensor, foot or toe, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57010","name":"Colpotomy drg pel abscess","description":"Colpotomy; with drainage of pelvic abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29861","name":"Hip arthro w/fb removal","description":"Arthroscopy, hip, surgical; with removal of loose body or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34830","name":"Open aortic tube prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; tube prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1558.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44900","name":"I&d appendix abscess open","description":"Incision and drainage of appendiceal abscess, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00740","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3894.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78265","name":"Gstr emptg img sm bwl trnst","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50382","name":"Change ureter stent percut","description":"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81237","name":"Ezh2 gene common variants","description":"Ezh2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large b-cell lymphoma) gene analysis, common variant(s) (eg, codon 646)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54328","name":"Revise penis/urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9505","name":"Tl201 thallium","description":"Thallium tl-201 thallous chloride, diagnostic, per millicurie","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11719","name":"Trim nail(s) any number","description":"Trimming of nondystrophic nails, any number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32674","name":"Thoracoscopy lymph node exc","description":"Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15220","name":"Fth/gft fr s/a/l 20 sq cm/<","description":"Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22551","name":"Arthrd ant ntrbdy cervical","description":"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below c2","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1524.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93459","name":"L hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter place","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2994.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47561","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93050","name":"Art pressure waveform analys","description":"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity art","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54411","name":"Remov/replc penis pros comp","description":"Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84425","name":"Assay of vitamin b-1","description":"Thiamine (vitamin b-1)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":716.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3794.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74283","name":"Ther nma rdctj intus/obstrcj","description":"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76930","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74230","name":"X-ray xm swlng funcj c+","description":"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49900","name":"Repair of abdominal wall","description":"Suture, secondary, of abdominal wall for evisceration or dehiscence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85540","name":"Wbc alkaline phosphatase","description":"Leukocyte alkaline phosphatase with count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52356","name":"Cysto/uretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, gibbons or double-j type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92590","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6228","name":"Gauze <= 16 sq in water/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63268","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1272.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33202","name":"Insert epicard eltrd open","description":"Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median sternotomy, subxiphoid approach)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78432","name":"Myocrd img pet 2rtracer","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68130","name":"Exc les conjunctiva adj scl","description":"Excision of lesion, conjunctiva; with adjacent sclera","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50280","name":"Exc/unroofing cyst kidney","description":"Excision or unroofing of cyst(s) of kidney","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":783.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77003","name":"Fluoroguide for spine inject","description":"Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11839.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":6237.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82365","name":"Calculus spectroscopy","description":"Calculus; infrared spectroscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6309.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33218","name":"Repair lead pace-defib one","description":"Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26455","name":"Incision of finger tendon","description":"Tenotomy, flexor, finger, open, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11442","name":"Exc face-mm b9+marg 1.1-2 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83993","name":"Assay for calprotectin fecal","description":"Calprotectin, fecal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47550","name":"Bile duct endoscopy add-on","description":"Biliary endoscopy, intraoperative (choledochoscopy) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97597","name":"Dbrdmt opn wnd 1st 20 cm/<","description":"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when perform","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41510","name":"Tongue to lip surgery","description":"Suture of tongue to lip for micrognathia (douglas type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11752","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65779","name":"Cover eye w/membrane suture","description":"Placement of amniotic membrane on the ocular surface; single layer, sutured","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64891","name":"Nrv grf 1strnd hnd/foot >4cm","description":"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94770","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86707","name":"Hepatitis be antibody","description":"Hepatitis be antibody (hbeab)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99422","name":"Ol dig e/m svc 11-20 min","description":"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20526","name":"Ther injection carp tunnel","description":"Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32505","name":"Wedge resect of lung initial","description":"Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46258","name":"Remove in/ex hem grp w/fistu","description":"Hemorrhoidectomy, internal and external, single column/group; with fistulectomy, including fissurectomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26951","name":"Amputation of finger/thumb","description":"Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15731","name":"Forehead flap w/vasc pedicle","description":"Forehead flap with preservation of vascular pedicle (eg, axial pattern flap, paramedian forehead flap)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29900","name":"Mcp joint arthroscopy dx","description":"Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43605","name":"Biopsy of stomach","description":"Biopsy of stomach, by laparotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95806","name":"Sleep study unatt&resp efft","description":"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26951","name":"Amputation of finger/thumb","description":"Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88272","name":"Cytogenetics 3-5","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83805","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64581","name":"Opn impltj nea sacral nerve","description":"Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74241","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82803","name":"Blood gases any combination","description":"Gases, blood, any combination of ph, pco2, po2, co2, hco3 (including calculated o2 saturation);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70546","name":"Mr angiograph head w/o&w/dye","description":"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23532","name":"Optx strclv dslc aq/chrn grf","description":"Open treatment of sternoclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7510","name":"Prosthetic device repair rep","description":"Repair of prosthetic device, repair or replace minor parts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26551","name":"Great toe-hand transfer","description":"Transfer, toe-to-hand with microvascular anastomosis; great toe wrap-around with bone graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2790.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2217.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17280","name":"Dstr mal ls f/e/e/n/l/m .5/<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31513","name":"Injection into vocal cord","description":"Laryngoscopy, indirect; with vocal cord injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33974","name":"Remove intra-aortic balloon","description":"Removal of intra-aortic balloon assist device from the ascending aorta, including repair of the ascending aorta, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73718","name":"Mri lower extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27695","name":"Repair of ankle ligament","description":"Repair, primary, disrupted ligament, ankle; collateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85396","name":"Clotting assay whole blood","description":"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","name":"Anes vaginal px nos","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75574","name":"Ct angio hrt w/3d image","description":"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70488","name":"Ct maxillofacial w/o & w/dye","description":"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64736","name":"Incision of chin nerve","description":"Transection or avulsion of; mental nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12031","name":"Intmd rpr s/a/t/ext 2.5 cm/<","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25442","name":"Arthrp w/prostc dstl ulna","description":"Arthroplasty with prosthetic replacement; distal ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64483","name":"Njx aa&/strd tfrm epi l/s 1","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), lumbar or sacral, single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52344","name":"Cysto/uretero stricture tx","description":"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53400","name":"Revise urethra stage 1","description":"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, johannsen type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51555","name":"Partial removal of bladder","description":"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42720","name":"I&d absc phrngl ntraorl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62270","name":"Dx lmbr spi pnxr","description":"Spinal puncture, lumbar, diagnostic;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73702","name":"Ct lwr extremity w/o&w/dye","description":"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93291","name":"Interrog dev eval scrms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; subcutaneous cardiac rhythm monitor system, including heart rhythm derived data analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24220","name":"Injection px for elbow arthg","description":"Injection procedure for elbow arthrography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75940","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33764","name":"Shunt central w/prostc graft","description":"Shunt; central, with prosthetic graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1140.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90817","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90823","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72133","name":"Ct lumbar spine w/o & w/dye","description":"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33258","name":"Ablate atria x10sv add-on","description":"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54235","name":"Njx corpora cavernosa rx agt","description":"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0103","name":"Psa screening","description":"Prostate cancer screening; prostate specific antigen test (psa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22210","name":"Incis 1 vertebral seg cerv","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24565","name":"Cltx hum epcndylr fx w/mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41251","name":"Repair tongue laceration","description":"Repair of laceration 2.5 cm or less; posterior one-third of tongue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95904","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1601.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85380","name":"Fibrin degradj d-dimer","description":"Fibrin degradation products, d-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45171","name":"Exc rect tum transanal part","description":"Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","name":"Anes male gent undscnd tstis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5546.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","name":"Anes clsd ch mediast&thrc w/","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"Home/res vst est low mdm 30","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64890","name":"Nrv grf 1strnd hnd/foot <4cm","description":"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85445","name":"Heinz bodies induced","description":"Heinz bodies; induced, acetyl phenylhydrazine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86828","name":"Hla class i&ii antibody qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to hla class i and class ii hla antigens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78351","name":"Bone mineral dual photon","description":"Bone density (bone mineral content) study, 1 or more sites; dual photon absorptiometry, 1 or more sites","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25107","name":"Remove wrist joint cartilage","description":"Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69676","name":"Remove middle ear nerve","description":"Tympanic neurectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37195","name":"Thrombolytic therapy stroke","description":"Thrombolysis, cerebral, by intravenous infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43770","name":"Lap place gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82382","name":"Assay urine catecholamines","description":"Catecholamines; total urine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9538","name":"Tc99m pyrophosphate","description":"Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93458","name":"L hrt artery/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49425","name":"Insert abdomen-venous drain","description":"Insertion of peritoneal-venous shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0400","name":"Home sleep test/type 4 porta","description":"Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59855","name":"Induced abortion 1+vag supp","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KF","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70481","name":"Ct orbit/ear/fossa w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84588","name":"Assay of vasopressin","description":"Vasopressin (antidiuretic hormone, adh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78478","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92953","name":"Temporary external pacing","description":"Temporary transcutaneous pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99232","name":"Sbsq hosp ip/obs moderate 35","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minut","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75724","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","name":"Anes/analg cs dlvr neuraxial","description":"Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61850","name":"Implant neuroelectrodes","description":"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74022","name":"Radex compl aqt abd series","description":"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43280","name":"Laparoscopy fundoplasty","description":"Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T5999","name":"Supply, nos","description":"Supply, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51795","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4793.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70546","name":"Mr angiograph head w/o&w/dye","description":"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32552","name":"Remove lung catheter","description":"Removal of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31625","name":"Bronchoscopy w/biopsy(s)","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95966","name":"Meg evoked single","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65436","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with application of chelating agent (eg, edta)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":103.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3320","name":"Shoe lift elev heel/sole cor","description":"Lift, elevation, heel and sole, cork, per inch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87502","name":"Influenza dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, first 2 types or sub-types","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7900","name":"Male vacuum erection system","description":"Male vacuum erection system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27030","name":"Arthrotomy hip w/drainage","description":"Arthrotomy, hip, with drainage (eg, infection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85520","name":"Heparin assay","description":"Heparin assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88235","name":"Tissue culture placenta","description":"Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72149","name":"Mri lumbar spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63741","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1850.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67850","name":"Dstrj lesion lid margin <1cm","description":"Destruction of lesion of lid margin (up to 1 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95938","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4810.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33130","name":"Rescj external cardiac tumor","description":"Resection of external cardiac tumor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1184.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33411","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2929.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","name":"Anes integ sys rad/modf brst","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27766","name":"Optx medial ankle fx","description":"Open treatment of medial malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61870","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74301","name":"X-rays at surgery add-on","description":"Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1887","name":"Catheter, guiding","description":"Catheter, guiding (may include infusion/perfusion capability)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73221","name":"Mri joint upr extrem w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80055","name":"Obstetric panel","description":"Obstetric panel this panel must include the following: blood count, complete (cbc), automated and automated differential wbc count (85025 or 85027 and 85004) or blood count, complete (cbc), automated (85027) and appropriate manual differential wbc count (85007 or 85009) hepatitis b surface antigen (","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99150","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76377","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58322","name":"Artificial insemination","description":"Artificial insemination; intra-uterine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0008","name":"Admin influenza virus vac","description":"Administration of influenza virus vaccine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69644","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1194.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31648","name":"Bronchial valve remov init","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), initial lobe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95700","name":"Eeg cont rec w/vid eeg tech","description":"Electroencephalogram (eeg) continuous recording, with video when performed, setup, patient education, and takedown when performed, administered in person by eeg technologist, minimum of 8 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25119","name":"Partial removal of ulna","description":"Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32482","name":"Bilobectomy","description":"Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1267.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67334","name":"Revise eye muscle w/suture","description":"Strabismus surgery by posterior fixation suture technique, with or without muscle recession (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28505","name":"Treat big toe fracture","description":"Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53520","name":"Repair of urethra defect","description":"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46762","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92612","name":"Endoscopy swallow (fees) vid","description":"Flexible endoscopic evaluation of swallowing by cine or video recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45379","name":"Colonoscopy w/fb removal","description":"Colonoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65135","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93225","name":"Xtrnl ecg rec<48 hrs rec","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connection, recording, and disconnection)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64600","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25391","name":"Lengthen radius or ulna","description":"Osteoplasty, radius or ulna; lengthening with autograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31600","name":"Planned tracheostomy","description":"Tracheostomy, planned (separate procedure);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3455.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31660","name":"Bronch thermoplsty 1 lobe","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2017.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21087","name":"Impres&prep nasal prosth","description":"Impression and custom preparation; nasal prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1318.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99488","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47531","name":"Injection for cholangiogram","description":"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0237","name":"Therapeutic procd strg endur","description":"Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37760","name":"Lig prfratr vn radical 1 leg","description":"Ligation of perforator veins, subfascial, radical (linton type), including skin graft, when performed, open,1 leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1390.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34490","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"Prev visit est age 40-64","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21085","name":"Impres&prep oral surg splint","description":"Impression and custom preparation; oral surgical splint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36861","name":"Cannula declotting","description":"External cannula declotting (separate procedure); with balloon catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24000","name":"Arthrt elbw expl drg/rmvl fb","description":"Arthrotomy, elbow, including exploration, drainage, or removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15301","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92996","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28122","name":"Partial removal of foot bone","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","name":"Anes dx/ther nrv blk&inj oth","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61616","name":"Resect/excise lesion skull","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or c1-c3 vertebral bodies; intradural, including dural repair, with or without graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2975.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4554","name":"Disposable underpads","description":"Disposable underpads, all sizes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50250","name":"Opn abltj 1/> rnl mas crysrg","description":"Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77770","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2116.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22819","name":"Kyphectomy 3 or more","description":"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 or more segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2117.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99484","name":"Care mgmt svc bhvl hlth cond","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of appli","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44156","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, with proctectomy; with continent ileostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1935.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55875","name":"Transperi needle place pros","description":"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64907","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; second stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64740","name":"Incision of tongue nerve","description":"Transection or avulsion of; lingual nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27762","name":"Cltx med ankle fx w/mnpj","description":"Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45135","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; abdominal and perineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55520","name":"Removal of sperm cord lesion","description":"Excision of lesion of spermatic cord (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76881","name":"Us compl joint r-t w/img","description":"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","name":"Anes integumentary sys nos","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45000","name":"Drainage of pelvic abscess","description":"Transrectal drainage of pelvic abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20697","name":"App mltpln uni xtrnl fix xch","description":"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60200","name":"Remove thyroid lesion","description":"Excision of cyst or adenoma of thyroid, or transection of isthmus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27424","name":"Revision/removal of kneecap","description":"Reconstruction of dislocating patella; with patellectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91038","name":"Esoph imped funct test > 1hr","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75680","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7916.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11004","name":"Dbrdmt skin xtrnl gent&per","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93975","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59870","name":"Evacuate mole of uterus","description":"Uterine evacuation and curettage for hydatidiform mole","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89049","name":"Chct for mal hyperthermia","description":"Caffeine halothane contracture test (chct) for malignant hyperthermia susceptibility, including interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58565","name":"Hysteroscopy sterilization","description":"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89055","name":"Leukocyte assessment fecal","description":"Leukocyte assessment, fecal, qualitative or semiquantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35656","name":"Bpg femoral-popliteal","description":"Bypass graft, with other than vein; femoral-popliteal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28160","name":"Partial removal of toe","description":"Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59400","name":"Obstetrical care","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1332.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":540.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01610","name":"Anes all px nrv musc sho&ax","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77406","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560T","name":"Antmc mdl 3d print ea addl","description":"Anatomic model 3d-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25000","name":"Incision of tendon sheath","description":"Incision, extensor tendon sheath, wrist (eg, de quervains disease)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","name":"Anes 2&3 burn less 4 % tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; less than 4% total body surface area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74262","name":"Ct colonography dx w/dye","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92285","name":"External ocular photography","description":"External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37218","name":"Stent placemt ante carotid","description":"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57156","name":"Ins vag brachytx device","description":"Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35102","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving iliac vessels (common, hypogastric, external)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1657.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19370","name":"Revj peri-implt capsule brst","description":"Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26518","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 3 or 4 digits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35525","name":"Art byp grft brachial-brchl","description":"Bypass graft, with vein; brachial-brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77777","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33530","name":"Coronary artery bypass/reop","description":"Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92072","name":"Fitg c-lens keratoconus 1st","description":"Fitting of contact lens for management of keratoconus, initial fitting","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2054.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38564","name":"Removal abdomen lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74170","name":"Ct abd wo cntrst flwd cntrst","description":"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85270","name":"Clot factor xi pta","description":"Clotting; factor xi (pta)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31032","name":"Explore sinus remove polyps","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) with removal of antrochoanal polyps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21356","name":"Opn tx dprsd zygomatic arch","description":"Open treatment of depressed zygomatic arch fracture (eg, gillies approach)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35454","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21012","name":"Exc face les sbq 2 cm/>","description":"Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74175","name":"Cta abdomen w/contrast","description":"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87807","name":"Rsv assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53200","name":"Biopsy of urethra","description":"Biopsy of urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93306","name":"Tte w/doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","name":"Anes ther ivntl rad artl nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92547","name":"Supplemental electrical test","description":"Use of vertical electrodes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15776","name":"Hair trnspl >15 punch grafts","description":"Punch graft for hair transplant; more than 15 punch grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87582","name":"M.pneumon dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22610","name":"Arthrd pst tq 1ntrspc thrc","description":"Arthrodesis, posterior or posterolateral technique, single interspace; thoracic (with lateral transverse technique, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24365","name":"Reconstruct head of radius","description":"Arthroplasty, radial head;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33730","name":"Repair heart-vein defect(s)","description":"Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1743.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0446","name":"Intens behave ther cardio dx","description":"Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62327","name":"Njx interlaminar lmbr/sac","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46744","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2967.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0434","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21685","name":"Hyoid myotomy & suspension","description":"Hyoid myotomy and suspension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61566","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2059.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27095","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; with anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69930","name":"Implant cochlear device","description":"Cochlear device implantation, with or without mastoidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30110","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0424","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85293","name":"Clot factor wght kininogen","description":"Clotting; high molecular weight kininogen assay (fitzgerald factor assay)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38700","name":"Removal of lymph nodes neck","description":"Suprahyoid lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44820","name":"Excision of mesentery lesion","description":"Excision of lesion of mesentery (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33803","name":"Div aberrant vsl w/reanast","description":"Division of aberrant vessel (vascular ring); with reanastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3530.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76102","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54660","name":"Revision of testis","description":"Insertion of testicular prosthesis (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71021","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20605","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77421","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33961","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54308","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3389.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15845","name":"Skin and muscle repair face","description":"Graft for facial nerve paralysis; regional muscle transfer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43284","name":"Laps esophgl sphnctr agmntj","description":"Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28119","name":"Removal of heel spur","description":"Ostectomy, calcaneus; for spur, with or without plantar fascial release","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78434","name":"Aqmbf pet rest & rx stress","description":"Absolute quantitation of myocardial blood flow (aqmbf), positron emission tomography (pet), rest and pharmacologic stress (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81210","name":"Braf gene","description":"Braf (b-raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, v600 variant(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15400","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49400","name":"Air injection into abdomen","description":"Injection of air or contrast into peritoneal cavity (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34845","name":"Visc & infraren abd 1 prosth","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1683.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15110","name":"Epidrm agrft t/a/l 1st 100","description":"Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87527","name":"Hepatitis g dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","BA","KE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44141","name":"Partial removal of colon","description":"Colectomy, partial; with skin level cecostomy or colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1509.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33019","name":"Perq prcrd drg insj cath ct","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including ct guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21268","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1702.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45340","name":"Sig w/tndsc balloon dilation","description":"Sigmoidoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27656","name":"Repair leg fascia defect","description":"Repair, fascial defect of leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3211","name":"Surgical boot each junior","description":"Surgical boot, each, junior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91013","name":"Esophgl motil w/stim/perfus","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93527","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23520","name":"Cltx strnclav dislc w/o mnpj","description":"Closed treatment of sternoclavicular dislocation; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99478","name":"Sbsq ic vlbw inf<1,500 gm","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering very low birth weight infant (present body weight less than 1,500 grams)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45108","name":"Anorectal myomectomy","description":"Anorectal myomectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31390","name":"Removal of larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; without reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2126.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55100","name":"Drainage of scrotum abscess","description":"Drainage of scrotal wall abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26705","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95983","name":"Alys brn npgt prgrmg 15 min","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96164","name":"Hlth bhv ivntj grp 1st 30","description":"Health behavior intervention, group (2 or more patients), face-to-face; initial 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55831","name":"Removal of prostate","description":"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83913","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27146","name":"Incision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47460","name":"Incise bile duct sphincter","description":"Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1601.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80174","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6404","name":"Sterile gauze > 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33985","name":"Ecmo/ecls rmvl ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22830","name":"Exploration of spinal fusion","description":"Exploration of spinal fusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33959","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88147","name":"Cytopath c/v automated","description":"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3201","name":"Oxford w supinat/pronat inf","description":"Orthopedic shoe, oxford with supinator or pronator, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77002","name":"Needle localization by xray","description":"Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90818","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86891","name":"Autologous blood op salvage","description":"Autologous blood or component, collection processing and storage; intra- or postoperative salvage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0085","name":"Care man h v ext pt 75 m","description":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69530","name":"Extensive mastoid surgery","description":"Petrous apicectomy including radical mastoidectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81514","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of dna markers for gardnerella vaginalis, atopobium vaginae, megasphaera type 1, bacterial vaginosis associated bacteria-2 (bvab-2), and lactobacillus species (l. crispatus and l. jensenii), utilizing vaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86805","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; with titration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3700","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45190","name":"Destruction rectal tumor","description":"Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33545","name":"Repair of heart damage","description":"Repair of postinfarction ventricular septal defect, with or without myocardial resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2677.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4161","name":"Ef ped hydrolyzed/amino acid","description":"Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56620","name":"Vulvectomy simple partial","description":"Vulvectomy simple; partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92517","name":"Vemp test i&r cervical","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; cervical (cvemp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57150","name":"Treat vagina infection","description":"Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2472.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46257","name":"Remove in/ex hem grp & fiss","description":"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99461","name":"Init nb em per day non-fac","description":"Initial care, per day, for evaluation and management of normal newborn infant seen in other than hospital or birthing center","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64611","name":"Chemodenerv saliv glands","description":"Chemodenervation of parotid and submandibular salivary glands, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94370","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21154","name":"Rcnstj mdfc lefort iii w/o i","description":"Reconstruction midface, lefort iii (extracranial), any type, requiring bone grafts (includes obtaining autografts); without lefort i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1592.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26180","name":"Removal of finger tendon","description":"Excision of tendon, finger, flexor or extensor, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1435.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84305","name":"Assay of somatomedin","description":"Somatomedin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74713","name":"Mri fetal ea addl gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44383","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63305","name":"Remove vert idrl body thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2296.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84484","name":"Assay of troponin quant","description":"Troponin, quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99415","name":"Prolng clin staff svc 1st hr","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (list separately in addition to code for out","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":964.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21452","name":"Perq tx mndblr fx xtrnl fixj","description":"Percutaneous treatment of mandibular fracture, with external fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75630","name":"X-ray aorta leg arteries","description":"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15260","name":"Fth/gft fr n/e/e/l 20 sqcm/<","description":"Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23020","name":"Capsular contracture release","description":"Capsular contracture release (eg, sever type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22315","name":"Closed tx vert fx w/manj","description":"Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting or bracing, with and including casting and/or bracing by manipulation or traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472T","name":"Prgrmg io rta eltrd ra","description":"Device evaluation, interrogation, and initial programming of intraocular retinal electrode array (eg, retinal prosthesis), in person, with iterative adjustment of the implantable device to test functionality, select optimal permanent programmed values with analysis, including visual training, with r","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21070","name":"Remove coronoid process","description":"Coronoidectomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83900","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97034","name":"App mdlty 1+cntrst bth ea 15","description":"Application of a modality to 1 or more areas; contrast baths, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31654","name":"Bronch ebus ivntj perph les","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s) (list separately in addition to code for primary procedure[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36514","name":"Apheresis plasma","description":"Therapeutic apheresis; for plasma pheresis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36557","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42340","name":"Removal of salivary stone","description":"Sialolithotomy; parotid, extraoral or complicated intraoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27846","name":"Treat ankle dislocation","description":"Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; without repair or internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","name":"Anes th ivnt rad ntrthrc/jug","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50570","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80430","name":"Growth hormone panel","description":"Growth hormone suppression panel (glucose administration) this panel must include the following: glucose (82947 x 3) human growth hormone (hgh) (83003 x 4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12017","name":"Rpr fe/e/en/l/m 20.1-30.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72147","name":"Mri chest spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93924","name":"Lwr xtr vasc stdy bilat","description":"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a st","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93244","name":"Ext ecg>48hr<7d rev&interpj","description":"External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; review and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26525","name":"Release finger contracture","description":"Capsulectomy or capsulotomy; interphalangeal joint, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76000","name":"Fluoroscopy <1 hr phys/qhp","description":"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24344","name":"Reconstruct elbow lat ligmnt","description":"Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24125","name":"Exc/crtg b1 cst/tum rds agrf","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35647","name":"Bpg aortofemoral","description":"Bypass graft, with other than vein; aortofemoral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87209","name":"Smear complex stain","description":"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95920","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93642","name":"Ep evl 1/2chmb trnsvns cvdfb","description":"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parame","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43775","name":"Lap sleeve gastrectomy","description":"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":939.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95079","name":"Ingest challenge addl 60 min","description":"Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance); each additional 60 minutes of testing (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67903","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84590","name":"Assay of vitamin a","description":"Vitamin a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81329","name":"Smn1 gene dos/deletion alys","description":"Smn1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes smn2 (survival of motor neuron 2, centromeric) analysis, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64483","name":"Njx aa&/strd tfrm epi l/s 1","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), lumbar or sacral, single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19126","name":"Excision addl breast lesion","description":"Excision of breast lesion identified by preoperative placement of radiological marker, open; each additional lesion separately identified by a preoperative radiological marker (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67975","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1597.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15819","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85525","name":"Heparin neutralization","description":"Heparin neutralization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90747","name":"Hepb vacc 4 dose immunsup im","description":"Hepatitis b vaccine (hepb), dialysis or immunosuppressed patient dosage, 4 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97022","name":"Whirlpool therapy","description":"Application of a modality to 1 or more areas; whirlpool","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65855","name":"Trabeculoplasty laser surg","description":"Trabeculoplasty by laser surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28322","name":"Repair of metatarsals","description":"Repair, nonunion or malunion; metatarsal, with or without bone graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4676.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":273.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27324","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29905","name":"Subtalar arthro w/exc","description":"Arthroscopy, subtalar joint, surgical; with synovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13132","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","description":"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64479","name":"Njx aa&/strd tfrm epi c/t 1","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), cervical or thoracic, single level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0476","name":"Hpv combo assay ca screen","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32503","name":"Resect apical lung tumor","description":"Resection of apical lung tumor (eg, pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; without chest wall reconstruction(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99292","name":"Critical care addl 30 min","description":"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68115","name":"Exc les conjunctiva >1 cm","description":"Excision of lesion, conjunctiva; over 1 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3160","name":"Shoe styled positioning dev","description":"Foot, adjustable shoe-styled positioning device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37221","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82154","name":"Androstanediol glucuronide","description":"Androstanediol glucuronide","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93892","name":"Tcd emboli detect w/o inj","description":"Transcranial doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32666","name":"Thoracoscopy w/wedge resect","description":"Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21555","name":"Exc neck les sc < 3 cm","description":"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27827","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of tibia only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27422","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, campbell, goldwaite type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99091","name":"Collj & interpj data ea 30 d","description":"Collection and interpretation of physiologic data (eg, ecg, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) r","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33031","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"Prev visit est age 12-17","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adole","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2992.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78460","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85002","name":"Bleeding time test","description":"Bleeding time","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64517","name":"N block inj hypogas plxs","description":"Injection, anesthetic agent; superior hypogastric plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45332","name":"Sigmoidoscopy w/fb removal","description":"Sigmoidoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28606","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61305","name":"Crnec/crnot expl infratntorl","description":"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10071.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31635","name":"Bronchoscopy w/fb removal","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97140","name":"Manual therapy 1/> regions","description":"Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2355.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":955.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52000","name":"Cystourethroscopy","description":"Cystourethroscopy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64911","name":"Neurorraphy w/vein autograft","description":"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75902","name":"Remove cva lumen obstruct","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93458","name":"L hrt artery/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4268","name":"Female condom","description":"Contraceptive supply, condom, female, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93622","name":"Comp ep eval l ventr pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29055","name":"Appl cast shoulder spica","description":"Application, cast; shoulder spica","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2008","name":"Post-d/c h vst ext pt 45 m","description":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient fac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27698","name":"Repair of ankle ligament","description":"Repair, secondary, disrupted ligament, ankle, collateral (eg, watson-jones procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86200","name":"Ccp antibody","description":"Cyclic citrullinated peptide (ccp), antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92340","name":"Fit spectacles monofocal","description":"Fitting of spectacles, except for aphakia; monofocal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36821","name":"Av fusion direct any site","description":"Arteriovenous anastomosis, open; direct, any site (eg, cimino type) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29260","name":"Strapping of elbow or wrist","description":"Strapping; elbow or wrist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","name":"Anes vag px crv cerclage","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66185","name":"Revise aqueous shunt eye","description":"Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91065","name":"Breath hydrogen/methane test","description":"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3842.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1464.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36100","name":"Establish access to artery","description":"Introduction of needle or intracatheter, carotid or vertebral artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34704","name":"Evasc rpr a-unilac ndgft rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2008.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25530","name":"Cltx ulnar shft fx w/o mnpj","description":"Closed treatment of ulnar shaft fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44128","name":"Enterectomy cong add-on","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; each additional resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0604","name":"Hosp grade elec breast pump","description":"Breast pump, hospital grade, electric (ac and / or dc), any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75959","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5199.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4726","name":"Dialys sol fld vol > 5999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83897","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11470","name":"Exc skn h/p/p/u smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with simple or intermediate repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99222","name":"1st hosp ip/obs moderate 55","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0638","name":"Standing frame sys","description":"Standing frame/table system, one position (e.g., upright, supine or prone stander), any size including pediatric, with or without wheels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43820","name":"Gastrojejunostomy wo vagotmy","description":"Gastrojejunostomy; without vagotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20985","name":"Cptr-asst dir ms px","description":"Computer-assisted surgical navigational procedure for musculoskeletal procedures, image-less (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24151","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":839.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35002","name":"Repair artery rupture neck","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, carotid, subclavian artery, by neck incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78481","name":"Heart first pass single","description":"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31575","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, flexible; diagnostic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44025","name":"Incision of large bowel","description":"Colotomy, for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":813.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31584","name":"Laryngoplasty fx rdctj fixj","description":"Laryngoplasty; with open reduction and fixation of (eg, plating) fracture, includes tracheostomy, if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53850","name":"Prostatic microwave thermotx","description":"Transurethral destruction of prostate tissue; by microwave thermotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67515","name":"Inject/treat eye socket","description":"Injection of medication or other substance into tenons capsule","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1501.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49185","name":"Sclerotx fluid collection","description":"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":904.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41140","name":"Removal of tongue","description":"Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1691.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87535","name":"Hiv-1 probe&reverse trnscrpj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27892","name":"Decompression of leg","description":"Decompression fasciotomy, leg; anterior and/or lateral compartments only, with debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11640","name":"Exc f/e/e/n/l mal+mrg 0.5cm<","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6020.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","name":"Anes px vn lwr leg ven thrmb","description":"Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512T","name":"Esw integ wnd hlg 1st wnd","description":"Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; initial wound","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68750","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35508","name":"Art byp grft carotid-vertbrl","description":"Bypass graft, with vein; carotid-vertebral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77520","name":"Proton trmt simple w/o comp","description":"Proton treatment delivery; simple, without compensation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19126","name":"Excision addl breast lesion","description":"Excision of breast lesion identified by preoperative placement of radiological marker, open; each additional lesion separately identified by a preoperative radiological marker (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67801","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, same lid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61651","name":"Evasc prlng admn rx agnt add","description":"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each additional vascular territory (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77771","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75671","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96931","name":"Rcm img acquisj&i&r 1st les","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, first lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92620","name":"Auditory function 60 min","description":"Evaluation of central auditory function, with report; initial 60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0329","name":"Electromagntic tx for ulcers","description":"Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51925","name":"Hysterectomy/bladder repair","description":"Closure of vesicouterine fistula; with hysterectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46320","name":"Removal of hemorrhoid clot","description":"Excision of thrombosed hemorrhoid, external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48556","name":"Removal allograft pancreas","description":"Removal of transplanted pancreatic allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4527","name":"Adult size pull-on lg","description":"Adult sized disposable incontinence product, protective underwear/pull-on, large size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27598","name":"Amputate lower leg at knee","description":"Disarticulation at knee","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6763.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4604.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92533","name":"Caloric vestibular test","description":"Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes 4 tests)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50125","name":"Pyelotomy w/drg pyelostomy","description":"Pyelotomy; with drainage, pyelostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28309","name":"Incision of metatarsals","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; multiple (eg, swanson type cavus foot procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51605","name":"Preparation for bladder xray","description":"Injection procedure and placement of chain for contrast and/or chain urethrocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47541","name":"Plmt access bil tree sm bwl","description":"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological superv","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27558","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair, with augmentation/reconstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28285","name":"Repair of hammertoe","description":"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75563","name":"Card mri w/stress img & dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57400","name":"Dilation of vagina","description":"Dilation of vagina under anesthesia (other than local)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16000","name":"Initial treatment of burn(s)","description":"Initial treatment, first degree burn, when no more than local treatment is required","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21627","name":"Sternal debridement","description":"Sternal debridement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50930","name":"Closure ureter/bowel fistula","description":"Closure of ureterovisceral fistula (including visceral repair)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23430","name":"Repair biceps tendon","description":"Tenodesis of long tendon of biceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"Immunization admin each add","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","name":"Anes upr gi ndsc px ercp","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ercp)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15740","name":"Island pedicle flap graft","description":"Flap; island pedicle requiring identification and dissection of an anatomically named axial vessel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","name":"Anes opn rpr fx disrpj plvs","description":"Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93613","name":"Intracardiac ephys 3d mapg","description":"Intracardiac electrophysiologic 3-dimensional mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81236","name":"Ezh2 gene full gene sequence","description":"Ezh2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33504","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4110.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1382.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19366","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40845","name":"Reconstruction of mouth","description":"Vestibuloplasty; complex (including ridge extension, muscle repositioning)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87101","name":"Skin fungi culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99493","name":"Sbsq psyc collab care mgmt","description":"Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required el","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95044","name":"Patch/application tests","description":"Patch or application test(s) (specify number of tests)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36465","name":"Njx noncmpnd sclrsnt 1 vein","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31630","name":"Bronchoscopy dilate/fx repr","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with tracheal/bronchial dilation or closed reduction of fracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68525","name":"Biopsy of tear sac","description":"Biopsy of lacrimal sac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83788","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86301","name":"Immunoassay tumor ca 19-9","description":"Immunoassay for tumor antigen, quantitative; ca 19-9","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KM","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61548","name":"Removal of pituitary gland","description":"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74183","name":"Mri abd w/o cntr flwd cntr","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88184","name":"Flowcytometry/ tc 1 marker","description":"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9987","name":"Bpci advanced in home visit","description":"Bundled payments for care improvement advanced (bpci advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/am","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11001","name":"Dbrdmt ecz/infct skn ea addl","description":"Debridement of extensive eczematous or infected skin; each additional 10% of the body surface, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87449","name":"Nos each organism ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; not otherwise specified, each organism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11602","name":"Exc tr-ext mal+marg 1.1-2 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40820","name":"Treatment of mouth lesion","description":"Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25355","name":"Revision of radius","description":"Osteotomy, radius; middle or proximal third","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80051","name":"Electrolyte panel","description":"Electrolyte panel this panel must include the following: carbon dioxide (bicarbonate) (82374) chloride (82435) potassium (84132) sodium (84295)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94005","name":"Home vent mgmt supervision","description":"Home ventilator management care plan oversight of a patient (patient not present) in home, domiciliary or rest home (eg, assisted living) requiring review of status, review of laboratories and other studies and revision of orders and respiratory care plan (as appropriate), within a calendar month, 3","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29305","name":"Appl hip spica cast 1 leg","description":"Application of hip spica cast; 1 leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20525","name":"Rmvl fb musc/tdn deep/comp","description":"Removal of foreign body in muscle or tendon sheath; deep or complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62201","name":"Brain cavity shunt w/scope","description":"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88313","name":"Special stains group 2","description":"Special stain including interpretation and report; group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24115","name":"Exc/crtg b1 cst/tum hum agrf","description":"Excision or curettage of bone cyst or benign tumor, humerus; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27036","name":"Capsulectomy/capsulotomy hip","description":"Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone, with release of hip flexor muscles (ie, gluteus medius, gluteus minimus, tensor fascia latae, rectus femoris, sartorius, iliopsoas)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35563","name":"Art byp grft ilioiliac","description":"Bypass graft, with vein; ilioiliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92584","name":"Electrocochleography","description":"Electrocochleography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11423","name":"Exc h-f-nk-sp b9+marg 2.1-3","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93320","name":"Doppler echo complete","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33463","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; without ring insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2676.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64746","name":"Incise diaphragm nerve","description":"Transection or avulsion of; phrenic nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92603","name":"Cochlear implt f/up exam 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; with programming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64864","name":"Repair of facial nerve","description":"Suture of facial nerve; extracranial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45382","name":"Colonoscopy w/control bleed","description":"Colonoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56820","name":"Colposcopy vulva","description":"Colposcopy of the vulva;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0108T","name":"Cool quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using cooling stimuli to assess small nerve fiber sensation and hyperalgesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7486.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93246","name":"Ext ecg>7d<15d recording","description":"External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; recording (includes connection and initial recording)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","name":"Anes upr gi ndsc px nos","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6309.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26520","name":"Release knuckle contracture","description":"Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36600","name":"Withdrawal of arterial blood","description":"Arterial puncture, withdrawal of blood for diagnosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","name":"Anes px art lower leg nos","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46070","name":"Incision anal septum infant","description":"Incision, anal septum (infant)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86778","name":"Toxoplasma antibody igm","description":"Antibody; toxoplasma, igm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63704","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; less than 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","name":"Anes 2&3 burn less 4 % tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; less than 4% total body surface area","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P3000","name":"Screen pap by tech w md supv","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77338","name":"Design mlc device for imrt","description":"Multi-leaf collimator (mlc) device(s) for intensity modulated radiation therapy (imrt), design and construction per imrt plan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4533","name":"Youth size brief/diaper","description":"Youth sized disposable incontinence product, brief/diaper, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57520","name":"Conization of cervix","description":"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66170","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29065","name":"Appl cst sho to hand lng arm","description":"Application, cast; shoulder to hand (long arm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15931","name":"Exc sacral pr ulc prim sutr","description":"Excision, sacral pressure ulcer, with primary suture;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1248.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58240","name":"Removal of pelvis contents","description":"Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64620","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, intercostal nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1314.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64580","name":"Opn impltj nea neuromuscular","description":"Open implantation of neurostimulator electrode array; neuromuscular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97537","name":"Community/work reintegration","description":"Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or work environment/modification analysis, work task analysis, use of assistive technology device/adaptive equipment), direct one-on-one contact, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","name":"Anes art sho&ax ax-fem bpg","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37700","name":"Ligation&div long saph vein","description":"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24079","name":"Rad rescj tum tiss a/e 5 cm+","description":"Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64893","name":"Nrv grf 1strnd arm/leg >4 cm","description":"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72082","name":"X-ray exam entire spi 2/3 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83012","name":"Assay of haptoglobins","description":"Haptoglobin; phenotypes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66700","name":"Destruction ciliary body","description":"Ciliary body destruction; diathermy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95711","name":"Veeg 2-12 hr unmonitored","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, 2-12 hours; unmonitored","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82104","name":"Alpha-1-antitrypsin pheno","description":"Alpha-1-antitrypsin; phenotype","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25116","name":"Remove wrist/forearm lesion","description":"Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, tbc, or other granulomas, rheumatoid arthritis); extensors, with or without transposition of dorsal retinaculum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88309","name":"Tissue exam by pathologist","description":"Level vi - surgical pathology, gross and microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection extremity, disarticulation fetus, with dissection larynx, partial/total resect","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86325","name":"Other immunoelectrophoresis","description":"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58740","name":"Adhesiolysis tube ovary","description":"Lysis of adhesions (salpingolysis, ovariolysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23532","name":"Optx strclv dslc aq/chrn grf","description":"Open treatment of sternoclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86808","name":"Cytotoxic antibody screening","description":"Serum screening for cytotoxic percent reactive antibody (pra); quick method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21085","name":"Impres&prep oral surg splint","description":"Impression and custom preparation; oral surgical splint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95147","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 3 single stinging insect venoms","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40520","name":"Partial excision of lip","description":"Excision of lip; v-excision with primary direct linear closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25024","name":"Decompress forearm 2 spaces","description":"Decompression fasciotomy, forearm and/or wrist, flexor and extensor compartment; without debridement of nonviable muscle and/or nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32601","name":"Thoracoscopy diagnostic","description":"Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, mediastinal or pleural space, without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83070","name":"Assay of hemosiderin qual","description":"Hemosiderin, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37201","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32110","name":"Explore/repair chest","description":"Thoracotomy; with control of traumatic hemorrhage and/or repair of lung tear","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99458","name":"Rpm tx mgmt ea addl 20 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93581","name":"Transcath closure of vsd","description":"Percutaneous transcatheter closure of a congenital ventricular septal defect with implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1422.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19100","name":"Bx breast percut w/o image","description":"Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54200","name":"Injection px peyronie ds","description":"Injection procedure for peyronie disease;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515T","name":"Insj wcs lv compl sys","description":"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; complete system (includes electrode and generator [transmitter and battery])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32160","name":"Open chest heart massage","description":"Thoracotomy; with cardiac massage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37205","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54901","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45345","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11363.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34826","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"Patient recorded spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; recording (includes hook-up, reinforced education, data transmission, data capture, trend analysis, and periodic recalibration)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32851","name":"Lung transplant single","description":"Lung transplant, single; without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2632.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36010","name":"Place catheter in vein","description":"Introduction of catheter, superior or inferior vena cava","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56821","name":"Colposcopy vulva w/biopsy","description":"Colposcopy of the vulva; with biopsy(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":576.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"Prev med cnsl indiv apprx 15","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77049","name":"Mri breast c-+ w/cad bi","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26320","name":"Removal of implant from hand","description":"Removal of implant from finger or hand","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35501","name":"Art byp grft ipsilat carotid","description":"Bypass graft, with vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5020","name":"Conformity evaluation","description":"Conformity evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73223","name":"Mri joint upr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5072.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74241","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86146","name":"Beta-2 glycoprotein antibody","description":"Beta 2 glycoprotein i antibody, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1893","name":"Intro/sheath, fixed,non-peel","description":"Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58410","name":"Suspension of uterus","description":"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with presacral sympathectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61795","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28320","name":"Repair of foot bones","description":"Repair, nonunion or malunion; tarsal bones","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92240","name":"Icg angiography i&r uni/bi","description":"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86651","name":"Encephalitis californ antbdy","description":"Antibody; encephalitis, california (la crosse)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67560","name":"Revise eye socket implant","description":"Orbital implant (implant outside muscle cone); removal or revision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62267","name":"Interdiscal perq aspir dx","description":"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2031.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28675","name":"Repair of toe dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26554","name":"Double transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, double","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3235.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93503","name":"Insert/place heart catheter","description":"Insertion and placement of flow directed catheter (eg, swan-ganz) for monitoring purposes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28116","name":"Revision of foot","description":"Ostectomy, excision of tarsal coalition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36476","name":"Endovenous rf vein add-on","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31505","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, indirect; diagnostic (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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)","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43117","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (ivor lewis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2708.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","name":"Anes art sho&ax ax-brch arsm","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84525","name":"Urea nitrogen semi-quant","description":"Urea nitrogen; semiquantitative (eg, reagent strip test)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35152","name":"Repair ruptd popliteal art","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, popliteal artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1234.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25800","name":"Arthrd wrist complete wo grf","description":"Arthrodesis, wrist; complete, without bone graft (includes radiocarpal and/or intercarpal and/or carpometacarpal joints)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0112","name":"Potassium hydroxide preps","description":"All potassium hydroxide (koh) preparations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38100","name":"Removal of spleen total","description":"Splenectomy; total (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75953","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6524.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30320","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; by lateral rhinotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0508","name":"Crit care telehea consult 60","description":"Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64517","name":"N block inj hypogas plxs","description":"Injection, anesthetic agent; superior hypogastric plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24800","name":"Arthrodesis elbw joint local","description":"Arthrodesis, elbow joint; local","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":701.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58293","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0212T","name":"Compre audiometry evaluation","description":"Comprehensive audiometry threshold evaluation and speech recognition (0209t, 0211t combined), automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69955","name":"Release facial nerve","description":"Total facial nerve decompression and/or repair (may include graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1596.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61500","name":"Crnec exc tum/bone les skull","description":"Craniectomy; with excision of tumor or other bone lesion of skull","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78494","name":"Heart image spect","description":"Cardiac blood pool imaging, gated equilibrium, spect, at rest, wall motion study plus ejection fraction, with or without quantitative processing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54415","name":"Remove self-contd penis pros","description":"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4306","name":"Drug delivery system <=50 ml","description":"Disposable drug delivery system, flow rate of less than 50 ml per hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75650","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97116","name":"Gait training therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5706.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01470","name":"Anes px nrv msc lw l/a/f nos","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","name":"Anes/analg cs dlvr neuraxial","description":"Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63102","name":"Remove vert body dcmprn lmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); lumbar, single segment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2003.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","name":"Anes iper upr abd pncrtect","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, whipple procedure)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86294","name":"Immunoassay tumor qual","description":"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77423","name":"Neutron beam tx complex","description":"High energy neutron radiation treatment delivery, 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge, and/or compensator(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33228","name":"Remv&replc pm gen dual lead","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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 ","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33960","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55120","name":"Removal of scrotum lesion","description":"Removal of foreign body in scrotum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82397","name":"Chemiluminescent assay","description":"Chemiluminescent assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98960","name":"Edu&trn pt self-mgmt nqhp 1","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35121","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, renal, or mesenteric artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4719","name":"Y set tubing","description":"Y set tubing for peritoneal dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92585","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91038","name":"Esoph imped funct test > 1hr","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99403","name":"Prev med cnsl indiv apprx 45","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1384.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4367.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20555","name":"Place ndl musc/tis for rt","description":"Placement of needles or catheters into muscle and/or soft tissue for subsequent interstitial radioelement application (at the time of or subsequent to the procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4456.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62321","name":"Njx interlaminar crv/thrc","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58542","name":"Lsh w/t/o ut 250 g or less","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24134","name":"Sequestrectomy shft/dstl hum","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal humerus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80420","name":"Dexamethasone panel","description":"Dexamethasone suppression panel, 48 hour this panel must include the following: free cortisol, urine (82530 x 2) cortisol (82533 x 2) volume measurement for timed collection (81050 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","name":"Anes male gent rad orch ing","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33762","name":"Shunt desc aorta to pulm art","description":"Shunt; descending aorta to pulmonary artery (potts-smith type operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L6025","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3897.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42900","name":"Repair throat wound","description":"Suture pharynx for wound or injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63250","name":"Revise spinal cord vsls crvl","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2742.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24164","name":"Removal prosth radial head","description":"Removal of prosthesis, includes debridement and synovectomy when performed; radial head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16035","name":"Escharotomy 1st incision","description":"Escharotomy; initial incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69120","name":"Removal of external ear","description":"Excision external ear; complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0076T","name":"S&i stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63199","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2006.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9037","name":"Plate pheres leukoredu irrad","description":"Platelets, pheresis, leukocytes reduced, irradiated, each unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27550","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4137.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81285","name":"Fxn gene charac alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":53.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93976","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4725","name":"Dialys sol fld vol > 4999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72146","name":"Mri chest spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0308","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21146","name":"Rcnstj mdfc lefort i 2 w/grf","description":"Reconstruction midface, lefort i; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral alveolar cleft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54437","name":"Repair corporeal tear","description":"Repair of traumatic corporeal tear(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71020","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69120","name":"Removal of external ear","description":"Excision external ear; complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36000","name":"Place needle in vein","description":"Introduction of needle or intracatheter, vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95962","name":"Electrode stim brain add-on","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83897","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61108","name":"Tdh pnxr evac&/drg sdrl hmta","description":"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33602","name":"Closure of valve","description":"Closure of semilunar valve (aortic or pulmonary) by suture or patch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93640","name":"Ep eval 1/2chmbr pacg cvdfb","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11363.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2187.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93281","name":"Pm device progr eval multi","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86161","name":"Complement/function activity","description":"Complement; functional activity, each component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44127","name":"Enterectomy w/taper cong","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; with tapering","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2403.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77059","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49587","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93453","name":"R&l hrt cath w/ventriclgrphy","description":"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50557","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86021","name":"Wbc antibody identification","description":"Antibody identification; leukocyte antibodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27638","name":"Remove/graft leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92548","name":"Cdp-sot 6 cond w/i&r","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74713","name":"Mri fetal ea addl gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84378","name":"Sugars single quant","description":"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64476","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26200","name":"Remove hand bone lesion","description":"Excision or curettage of bone cyst or benign tumor of metacarpal;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23140","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87116","name":"Mycobacteria culture","description":"Culture, tubercle or other acid-fast bacilli (eg, tb, afb, mycobacteria) any source, with isolation and presumptive identification of isolates","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28705","name":"Arthrodesis pantalar","description":"Arthrodesis; pantalar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45333","name":"Sigmoidoscopy & polypectomy","description":"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0409","name":"Corf related serv 15 mins ea","description":"Social work and psychological services, directly relating to and/or furthering the patients rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66155","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; thermocauterization with iridectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4337.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89136","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38115","name":"Repair of ruptured spleen","description":"Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77049","name":"Mri breast c-+ w/cad bi","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33989","name":"Removal of left heart vent","description":"Removal of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ecmo/ecls","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20661","name":"Application halo cranial","description":"Application of halo, including removal; cranial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27130","name":"Total hip arthroplasty","description":"Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1150.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25230","name":"Partial removal of radius","description":"Radial styloidectomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46706","name":"Repr of anal fistula w/glue","description":"Repair of anal fistula with fibrin glue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50600","name":"Exploration of ureter","description":"Ureterotomy with exploration or drainage (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72194","name":"Ct pelvis w/o & w/dye","description":"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36145","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61867","name":"Implant neuroelectrode","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2092.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73202","name":"Ct uppr extremity w/o&w/dye","description":"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43265","name":"Ercp lithotripsy calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49000","name":"Exploration of abdomen","description":"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23470","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; hemiarthroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1467.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55842","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":948.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62360","name":"Insert spine infusion device","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19304","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27535","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33777","name":"Rpr tga bfl rpr sbpulm obstr","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with repair of subpulmonic obstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1645.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33477","name":"Implant tcat pulm vlv perq","description":"Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","name":"Anes open/arthr ntrthrc amp","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; interthoracoscapular (forequarter) amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15823","name":"Blepharp upr eyelid xcsv skn","description":"Blepharoplasty, upper eyelid; with excessive skin weighting down lid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21210","name":"Face bone graft","description":"Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9987","name":"Bpci advanced in home visit","description":"Bundled payments for care improvement advanced (bpci advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/am","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9870","name":"Cmmi asyntelehealth >20min","description":"Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, more than 20 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12047","name":"Intmd rpr n-hf/genit >30.0cm","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27295","name":"Amputation of leg at hip","description":"Disarticulation of hip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72148","name":"Mri lumbar spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81190","name":"Cstb gene known famil vrnt","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; known familial variant(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25073","name":"Exc forearm tum deep 3 cm/>","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3339.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46608","name":"Anoscopy remove for body","description":"Anoscopy; with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36516","name":"Apheresis immunoads slctv","description":"Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1579.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3208.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86922","name":"Compatibility test antiglob","description":"Compatibility test each unit; antiglobulin technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87255","name":"Genet virus isolate hsv","description":"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38745","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42830","name":"Removal of adenoids","description":"Adenoidectomy, primary; younger than age 12","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49250","name":"Excision of umbilicus","description":"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1685.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37251","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92228","name":"Img rta detc/mntr ds phy/qhp","description":"Imaging of retina for detection or monitoring of disease; with remote physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73542","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82180","name":"Assay of ascorbic acid","description":"Ascorbic acid (vitamin c), blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46270","name":"Remove anal fist subq","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0456","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21155","name":"Rcnstj mdfc lefort iii w/i","description":"Reconstruction midface, lefort iii (extracranial), any type, requiring bone grafts (includes obtaining autografts); with lefort i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97012","name":"Mechanical traction therapy","description":"Application of a modality to 1 or more areas; traction, mechanical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99150","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44360","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68801","name":"Dilate tear duct opening","description":"Dilation of lacrimal punctum, with or without irrigation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82088","name":"Assay of aldosterone","description":"Aldosterone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20251","name":"Biopsy vrt bdy open lmbr/crv","description":"Biopsy, vertebral body, open; lumbar or cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1940.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27227","name":"Treat hip fracture(s)","description":"Open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, with internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1403.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41108","name":"Biopsy of floor of mouth","description":"Biopsy of floor of mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3255.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93619","name":"Comprehensive ep evaluation","description":"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82107","name":"Alpha-fetoprotein l3","description":"Alpha-fetoprotein (afp); afp-l3 fraction isoform and total afp (including ratio)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22810","name":"Arthrd ant dfrm 4-7 vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1812.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44901","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31528","name":"Laryngoscopy and dilation","description":"Laryngoscopy direct, with or without tracheoscopy; with dilation, initial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33238","name":"Remove electrode/thoracotomy","description":"Removal of permanent transvenous electrode(s) by thoracotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24605","name":"Tx clsd elbow dislc req anes","description":"Treatment of closed elbow dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33534","name":"Cabg arterial two","description":"Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23333","name":"Remove shoulder fb deep","description":"Removal of foreign body, shoulder; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27634","name":"Exc leg/ankle tum dep 5 cm/>","description":"Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93981","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82190","name":"Atomic absorption","description":"Atomic absorption spectroscopy, each analyte","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1731.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":912.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0141","name":"Scr c/v cyto,autosys and md","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1459.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49580","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27286","name":"Arthrd hip jt sbtrchc osteot","description":"Arthrodesis, hip joint (including obtaining graft); with subtrochanteric osteotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41135","name":"Tongue and neck surgery","description":"Glossectomy; partial, with unilateral radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1683.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","name":"Anes male gent compl amp pns","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); complete amputation of penis","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96415","name":"Chemo iv infusion addl hr","description":"Chemotherapy administration, intravenous infusion technique; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22859","name":"Insj biomechanical device","description":"Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0342","name":"Laparoscopy islet cell trans","description":"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64760","name":"Incision of vagus nerve","description":"Transection or avulsion of; vagus nerve (vagotomy), abdominal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31070","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; external, simple (trephine operation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2451.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31290","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44202","name":"Lap enterectomy","description":"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L4380","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46211","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37209","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99490","name":"Chrnc care mgmt staff 1st 20","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37790","name":"Penile venous occlusion","description":"Penile venous occlusive procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28312","name":"Revision of toe","description":"Osteotomy, shortening, angular or rotational correction; other phalanges, any toe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36580","name":"Replace cvad cath","description":"Replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55605","name":"Vesiculotomy complicated","description":"Vesiculotomy; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90802","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25078","name":"Resect forarm/wrist tum 3cm>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9276","name":"Disposable sensor, cgm sys","description":"Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91010","name":"Esophagus motility study","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37237","name":"Open/perq place stent ea add","description":"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all a","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15781","name":"Dermabrasion segmental face","description":"Dermabrasion; segmental, face","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35236","name":"Repair blvsl vn grf uxtr","description":"Repair blood vessel with vein graft; upper extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17314","name":"Mohs addl stage t/a/l","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78429","name":"Myocrd img pet 1 std w/ct","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33017","name":"Prcrd drg 6yr+ w/o cgen car","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; 6 years and older without congenital cardiac anomaly","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50500","name":"Repair of kidney wound","description":"Nephrorrhaphy, suture of kidney wound or injury","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28193","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9483","name":"Remote e/m new pt 30mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real tim","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65130","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after evisceration, in scleral shell","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95874","name":"Guide nerv destr needle emg","description":"Needle electromyography for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3786.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7529.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34841","name":"Endovasc visc aorta 1 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27592","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; open, circular (guillotine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3914.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82742","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36660","name":"Insertion catheter artery","description":"Catheterization, umbilical artery, newborn, for diagnosis or therapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33417","name":"Repair of aortic valve","description":"Aortoplasty (gusset) for supravalvular stenosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1446.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50436","name":"Dilat xst trc ndurlgc px","description":"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28600","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42100","name":"Biopsy roof of mouth","description":"Biopsy of palate, uvula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51080","name":"Drainage of bladder abscess","description":"Drainage of perivesical or prevesical space abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0396","name":"Alcohol/subs interv 15-30mn","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87449","name":"Nos each organism ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; not otherwise specified, each organism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93623","name":"Prgrmd stimj&pacg iv rx nfs","description":"Programmed stimulation and pacing after intravenous drug infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4629.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2179.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53445","name":"Insert uro/ves nck sphincter","description":"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"Esrd home pt serv p mo 20+","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 20 years of age and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93724","name":"Elec alys antitchycar pm sys","description":"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84482","name":"T3 reverse","description":"Triiodothyronine t3; reverse","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23200","name":"Radical rescj tumor clavicle","description":"Radical resection of tumor; clavicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2061.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2422.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51060","name":"Removal of ureter stone","description":"Transvesical ureterolithotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59851","name":"Induced abortion 1+njx d&c","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31572","name":"Largsc w/laser dstrj les","description":"Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3912.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36468","name":"Njx sclrsnt spider veins","description":"Injection(s) of sclerosant for spider veins (telangiectasia), limb or trunk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57284","name":"Repair paravag defect open","description":"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0104","name":"Ca screen;flexi sigmoidscope","description":"Colorectal cancer screening; flexible sigmoidoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51050","name":"Removal of bladder stone","description":"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6256","name":"Absorpt drg > 48 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27722","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with sliding graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97545","name":"Work hardening","description":"Work hardening/conditioning; initial 2 hours","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69200","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; without general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11303","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45126","name":"Pelvic exenteration","description":"Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy, or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), or any combination thereof","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2204.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93283","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantab","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"Esrd srv 4 visits p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36830","name":"Artery-vein nonautograft","description":"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472T","name":"Prgrmg io rta eltrd ra","description":"Device evaluation, interrogation, and initial programming of intraocular retinal electrode array (eg, retinal prosthesis), in person, with iterative adjustment of the implantable device to test functionality, select optimal permanent programmed values with analysis, including visual training, with r","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50437","name":"Dilat xst trc new access rcs","description":"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed; including new access into the renal collecting sys","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61863","name":"Implant neuroelectrode","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; first array","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76813","name":"Ob us nuchal meas 1 gest","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24345","name":"Repr elbw med ligmnt w/tissu","description":"Repair medial collateral ligament, elbow, with local tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25445","name":"Arthrp w/prostc trapezium","description":"Arthroplasty with prosthetic replacement; trapezium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56625","name":"Vulvectomy simple complete","description":"Vulvectomy simple; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00810","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97129","name":"Ther ivntj 1st 15 min","description":"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87501","name":"Influenza dna amp prob 1+","description":"Infectious agent detection by nucleic acid (dna or rna); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13374.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67923","name":"Repair eyelid defect","description":"Repair of entropion; excision tarsal wedge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0459","name":"Telehealth inpt pharm mgmt","description":"Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17263","name":"Dstrj mal les t/a/l 2.1-3.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5469.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4146.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78461","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1266.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99335","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21630","name":"Radical resection sternum","description":"Radical resection of sternum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31628","name":"Bronchoscopy/lung bx each","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51797","name":"Intraabdominal pressure test","description":"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":68.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27337","name":"Exc thigh/knee les sc 3 cm/>","description":"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4220","name":"Infusion pump refill kit","description":"Refill kit for implantable infusion pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69501","name":"Mastoidectomy","description":"Transmastoid antrotomy (simple mastoidectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27267","name":"Cltx thigh fx","description":"Closed treatment of femoral fracture, proximal end, head; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4097","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33418","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1556.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":872.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7523","name":"Tracheostomy shower protect","description":"Tracheostomy shower protector, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62284","name":"Injection for myelogram","description":"Injection procedure for myelography and/or computed tomography, lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":439.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","name":"Anes upr gi ndsc px ercp","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ercp)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49324","name":"Lap insert tunnel ip cath","description":"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17437.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3206","name":"Hightop w/ supp/pronator chi","description":"Orthopedic shoe, hightop with supinator or pronator, child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64605","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37203","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1459.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46748","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; with vaginal lengthening by intestinal graft or pedicle flaps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3561.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77071","name":"Mnl appl strs jt radiography","description":"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1751","name":"Cath, inf, per/cent/midline","description":"Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87336","name":"Entamoeb hist dispr ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; entamoeba histolytica dispar group","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85250","name":"Clot factor ix ptc/chrstmas","description":"Clotting; factor ix (ptc or christmas)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64494","name":"Inj paravert f jnt l/s 2 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9051.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35511","name":"Art byp grft subclav-subclav","description":"Bypass graft, with vein; subclavian-subclavian","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95708","name":"Eeg wo vid ea 12-26hr unmntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, each increment of 12-26 hours; unmonitored","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46258","name":"Remove in/ex hem grp w/fistu","description":"Hemorrhoidectomy, internal and external, single column/group; with fistulectomy, including fissurectomy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87560","name":"M.avium-intra dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","BA","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25607","name":"Optx dst rd xartc fx/epi sep","description":"Open treatment of distal radial extra-articular fracture or epiphyseal separation, with internal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33141","name":"Heart tmr w/other procedure","description":"Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86821","name":"Lymphocyte culture mixed","description":"Hla typing; lymphocyte culture, mixed (mlc)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40650","name":"Rpr lip fth vermilion only","description":"Repair lip, full thickness; vermilion only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44615","name":"Intestinal stricturoplasty","description":"Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for intestinal obstruction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93308","name":"Tte f-up or lmtd","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45388","name":"Colonoscopy w/ablation","description":"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67450","name":"Explore/biopsy eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); for exploration, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61720","name":"Incise skull/brain surgery","description":"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45385","name":"Colonoscopy w/lesion removal","description":"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44640","name":"Repair bowel-skin fistula","description":"Closure of intestinal cutaneous fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1154.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11424","name":"Exc h-f-nk-sp b9+marg 3.1-4","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47553","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","name":"Anes px arteries upr leg nos","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17270","name":"Dstr mal les s/n/h/f/g .5 /<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","53"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95808","name":"Polysom any age 1-3> param","description":"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26185","name":"Remove finger bone","description":"Sesamoidectomy, thumb or finger (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3157.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77079","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31225","name":"Removal of upper jaw","description":"Maxillectomy; without orbital exenteration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1367.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43215","name":"Esophagoscopy flex remove fb","description":"Esophagoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0368","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55725","name":"Drainage of prostate abscess","description":"Prostatotomy, external drainage of prostatic abscess, any approach; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57311","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula; with bulbocavernosus transplant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61735","name":"Incise skull/brain surgery","description":"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1453.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5100.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57130","name":"Excision vaginal septum","description":"Excision of vaginal septum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","name":"Anes all px neck nos 1yr/>","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0327","name":"Colon ca scrn;bld-bsd biomrk","description":"Colorectal cancer screening; blood-based biomarker","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88313","name":"Special stains group 2","description":"Special stain including interpretation and report; group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57320","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37180","name":"Revision of circulation","description":"Venous anastomosis, open; splenorenal, proximal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1872.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95052","name":"Photo patch tests","description":"Photo patch test(s) (specify number of tests)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92987","name":"Revision of mitral valve","description":"Percutaneous balloon valvuloplasty; mitral valve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80440","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37565","name":"Ligation int jugular vein","description":"Ligation, internal jugular vein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49452","name":"Replace g-j tube perc","description":"Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83900","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47360","name":"Repair liver wound","description":"Management of liver hemorrhage; complex suture of liver wound or injury, with or without hepatic artery ligation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["AW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29750","name":"Wedging of clubfoot cast","description":"Wedging of clubfoot cast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42820","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; younger than age 12","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50780","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of single ureter to bladder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63307","name":"Remov vert idrl bdy lmbr/sac","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2211.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47420","name":"Incision of bile duct","description":"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95851","name":"Range of motion measurements","description":"Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66761","name":"Revision of iris","description":"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1935.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2780.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21436","name":"Optx crnfcl sep comp mlt int","description":"Open treatment of craniofacial separation (lefort iii type); complicated, multiple surgical approaches, internal fixation, with bone grafting (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66682","name":"Repair iris & ciliary body","description":"Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, mccannel suture)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53260","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral polyp(s), distal urethra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47711","name":"Excision of bile duct tumor","description":"Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00528","name":"Anes clsd ch mediast&thrc wo","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22630","name":"Arthrd pst tq 1ntrspc lum","description":"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1412.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75560","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2492.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30130","name":"Excise inferior turbinate","description":"Excision inferior turbinate, partial or complete, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92524","name":"Behavral qualit analys voice","description":"Behavioral and qualitative analysis of voice and resonance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45113","name":"Partial proctectomy","description":"Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (s or j), with or without loop ileostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1460.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22841","name":"Insert spine fixation device","description":"Internal spinal fixation by wiring of spinous processes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77031","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37187","name":"Venous mech thrombectomy","description":"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42300","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66505","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77386","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28238","name":"Revision of foot tendon","description":"Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (eg, kidner type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35691","name":"Art trnsposj vertbrl carotid","description":"Transposition and/or reimplantation; vertebral to carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11450","name":"Exc skn hdrdnt ax smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or intermediate repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10008","name":"Fna bx w/fluor gdn ea addl","description":"Fine needle aspiration biopsy, including fluoroscopic guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0104","name":"Ca screen;flexi sigmoidscope","description":"Colorectal cancer screening; flexible sigmoidoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45805","name":"Repair fistula w/colostomy","description":"Closure of rectovesical fistula; with colostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61512","name":"Crnec treph exc mngioma sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2344.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87327","name":"Cryptococcus neoform ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cryptococcus neoformans","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90819","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87540","name":"Legion pneumo dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49203","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0870","name":"Pwc gp 4 hd seat/back","description":"Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86663","name":"Epstein-barr antibody","description":"Antibody; epstein-barr (eb) virus, early antigen (ea)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27324","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97811","name":"Acup 1/> w/o estim ea add 15","description":"Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87521","name":"Hepatitis c probe&rvrs trnsc","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"Im admin 1st/only component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24935","name":"Revision of amputation","description":"Stump elongation, upper extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94610","name":"Intrapulm surfactant admn","description":"Intrapulmonary surfactant administration by a physician or other qualified health care professional through endotracheal tube","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1634.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77385","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3331.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43135","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1219.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3296.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88312","name":"Special stains group 1","description":"Special stain including interpretation and report; group i for microorganisms (eg, acid fast, methenamine silver)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22533","name":"Arthrd lat xtrcvtry tq lmbr","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27560","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; without anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6473.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3375.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","name":"Anes opn upr 2/3 fem rad res","description":"Anesthesia for open procedures involving upper two-thirds of femur; radical resection","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46746","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3278.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40843","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90813","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4403.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13160","name":"Sec clsr surg wnd/dehsn xtn","description":"Secondary closure of surgical wound or dehiscence, extensive or complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54408","name":"Repair multi-comp penis pros","description":"Repair of component(s) of a multi-component, inflatable penile prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15320","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2365.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70482","name":"Ct orbit/ear/fossa w/o&w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90476","name":"Adenovirus vaccine type 4","description":"Adenovirus vaccine, type 4, live, for oral use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4550","name":"Surgical trays","description":"Surgical trays","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76983","name":"Use ea addl target lesion","description":"Ultrasound, elastography; each additional target lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27652","name":"Repair/graft achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon; with graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69718","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95801","name":"Slp stdy unatnd w/anal","description":"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21081","name":"Impres&prep mndbl res prosth","description":"Impression and custom preparation; mandibular resection prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5797.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20700","name":"Mnl prep&insj dp rx dlvr dev","description":"Manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87637","name":"Sarscov2&inf a&b&rsv amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), influenza virus types a and b, and respiratory syncytial virus, multiplex amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99476","name":"Ped crit care age 2-5 subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3371.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50553","name":"Kidney endoscopy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83700","name":"Lipopro bld electrophoretic","description":"Lipoprotein, blood; electrophoretic separation and quantitation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86723","name":"Listeria monocytogenes","description":"Antibody; listeria monocytogenes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47122","name":"Extensive removal of liver","description":"Hepatectomy, resection of liver; trisegmentectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2874.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83909","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28435","name":"Cltx talus fracture w/mnpj","description":"Closed treatment of talus fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84375","name":"Chromatogram assay sugars","description":"Sugars, chromatographic, tlc or paper chromatography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21813","name":"Treatment of rib fracture","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 7 or more ribs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27158","name":"Revision of pelvis","description":"Osteotomy, pelvis, bilateral (eg, congenital malformation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26210","name":"Removal of finger lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65101","name":"Removal of eye","description":"Enucleation of eye; without implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","name":"Anes nrv msc upr a&e tnplsty","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88152","name":"Cytopath c/v auto redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34900","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0191","name":"Misoprostol, oral, 200 mcg","description":"Misoprostol, oral, 200 mcg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46060","name":"I&d ischiorectal/ntrmrl absc","description":"Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49429","name":"Removal of shunt","description":"Removal of peritoneal-venous shunt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15793","name":"Chemical peel nonfacial drm","description":"Chemical peel, nonfacial; dermal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33987","name":"Artery expos/graft artery","description":"Arterial exposure with creation of graft conduit (eg, chimney graft) to facilitate arterial perfusion for ecmo/ecls (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33863","name":"Ascending aortic graft","description":"Ascending aorta graft, with cardiopulmonary bypass, with aortic root replacement using valved conduit and coronary reconstruction (eg, bentall)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2749.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87015","name":"Specimen infect agnt concntj","description":"Concentration (any type), for infectious agents","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0182","name":"Hospice care supervision","description":"Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other stu","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26842","name":"Thumb fusion with graft","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","name":"Anes dx/ther nrv blk&inj oth","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2396.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33881","name":"Evasc rpr ta ndgft xcov lsa","description":"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment of an aorto-aortic tube endograft not involving coverage of the left subclavian artery origin and all","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1347.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33406","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with allograft valve (freehand)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36573","name":"Insj picc rs&i 5 yr+","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; age 5 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0403","name":"Ekg for initial prevent exam","description":"Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1376.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40810","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92992","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51600","name":"Injection for bladder x-ray","description":"Injection procedure for cystography or voiding urethrocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69970","name":"Remove inner ear lesion","description":"Removal of tumor, temporal bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1729.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42426","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77785","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38232","name":"Bone marrow harvest autolog","description":"Bone marrow harvesting for transplantation; autologous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4708.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51585","name":"Removal of bladder & nodes","description":"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1706.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":100.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1009.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83898","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59012","name":"Fetal cord puncture prenatal","description":"Cordocentesis (intrauterine), any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87274","name":"Herpes simplex 1 ag if","description":"Infectious agent antigen detection by immunofluorescent technique; herpes simplex virus type 1","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92132","name":"Cptrzd oph dx img ant sgm","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), anterior segment, with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474T","name":"Insj aqueous drg dev io rsvr","description":"Insertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78461","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31591","name":"Laryngoplasty medialization","description":"Laryngoplasty, medialization, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80428","name":"Growth hormone panel","description":"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) this panel must include the following: human growth hormone (hgh) (83003 x 4)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60000","name":"I&d thyroglssl dux cst infct","description":"Incision and drainage of thyroglossal duct cyst, infected","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13102","name":"Cmplx rpr trunk addl 5cm/<","description":"Repair, complex, trunk; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","name":"Anes px male gent orchiopexy","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8699.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32667","name":"Thoracoscopy w/w resect addl","description":"Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88332","name":"Path consltj surg ea add blk","description":"Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15734","name":"Muscle-skin graft trunk","description":"Muscle, myocutaneous, or fasciocutaneous flap; trunk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8052.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83892","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86885","name":"Coombs test indirect qual","description":"Antihuman globulin test (coombs test); indirect, qualitative, each reagent red cell","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35631","name":"Bpg aor-celiac-msn-renal","description":"Bypass graft, with other than vein; aortoceliac, aortomesenteric, aortorenal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1634.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81443","name":"Genetic tstg severe inh cond","description":"Genetic testing for severe inherited conditions (eg, cystic fibrosis, ashkenazi jewish-associated disorders [eg, bloom syndrome, canavan disease, fanconi anemia type c, mucolipidosis type vi, gaucher disease, tay-sachs disease], beta hemoglobinopathies, phenylketonuria, galactosemia), genomic sequen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1224.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12020","name":"Tx supfc wnd dehsn smpl clsr","description":"Treatment of superficial wound dehiscence; simple closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43456","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8925.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24935","name":"Revision of amputation","description":"Stump elongation, upper extremity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73706","name":"Ct angio lwr extr w/o&w/dye","description":"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":1376.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444T","name":"1st plmt drug elut oc ins","description":"Initial placement of a drug-eluting ocular insert under one or more eyelids, including fitting, training, and insertion, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95830","name":"Insert electrodes for eeg","description":"Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (eeg) recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45381","name":"Colonoscopy submucous njx","description":"Colonoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81345","name":"Tert gene targeted seq alys","description":"Tert (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26474","name":"Fusion of finger tendons","description":"Tenodesis; of distal joint, each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92140","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27187","name":"Reinforce hip bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, femoral neck and proximal femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64653","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33230","name":"Insrt pulse gen w/dual leads","description":"Insertion of implantable defibrillator pulse generator only; with existing dual leads","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43405","name":"Ligate/staple esophagus","description":"Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86309","name":"Heterophile antibody titer","description":"Heterophile antibodies; titer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2032.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43213","name":"Esophagoscopy retro balloon","description":"Esophagoscopy, flexible, transoral; with dilation of esophagus, by balloon or dilator, retrograde (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63045","name":"Lam facetec & foramot crv","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70557","name":"Mri brain w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81336","name":"Smn1 gene full gene sequence","description":"Smn1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78802","name":"Rp loclzj tum whbdy 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, single day imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37234","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1942.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50980","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41008","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85300","name":"Antithrombin iii activity","description":"Clotting inhibitors or anticoagulants; antithrombin iii, activity","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80158","name":"Drug assay cyclosporine","description":"Cyclosporine","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74210","name":"X-ray xm phrnx&/crv esoph c+","description":"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31298","name":"Nsl/sins ndsc surg frnt&sphn","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33677","name":"Cl mult vsd w/rem pul band","description":"Closure of multiple ventricular septal defects; with removal of pulmonary artery band, with or without gusset","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1830.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33884","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4180","name":"Parenteral sol carb > 50%","description":"Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11622","name":"Exc s/n/h/f/g mal+mrg 1.1-2","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87339","name":"H pylori ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; helicobacter pylori","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85048","name":"Automated leukocyte count","description":"Blood count; leukocyte (wbc), automated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89051","name":"Body fluid cell count","description":"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3173.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74249","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87272","name":"Cryptosporidium ag if","description":"Infectious agent antigen detection by immunofluorescent technique; cryptosporidium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93975","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83499","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25375","name":"Revise radius & ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius and ulna","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87147","name":"Culture type immunologic","description":"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20693","name":"Adjmt/revj ext fixj sys anes","description":"Adjustment or revision of external fixation system requiring anesthesia (eg, new pin[s] or wire[s] and/or new ring[s] or bar[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4772","name":"Blood glucose test strips","description":"Blood glucose test strips, for dialysis, per 50","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8105.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38210","name":"T-cell depletion of harvest","description":"Transplant preparation of hematopoietic progenitor cells; specific cell depletion within harvest, t-cell depletion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36832","name":"Av fistula revision open","description":"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21175","name":"Rcnst bfrnt sp orb rm&lw fhd","description":"Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11306","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86606","name":"Aspergillus antibody","description":"Antibody; aspergillus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87515","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27646","name":"Resect fibula tumor","description":"Radical resection of tumor; fibula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86602","name":"Antinomyces antibody","description":"Antibody; actinomyces","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58353","name":"Endometr ablate thermal","description":"Endometrial ablation, thermal, without hysteroscopic guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93621","name":"Comp ep evl l pac&rec c sins","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1779.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2999","name":"Lower extremity orthosis nos","description":"Lower extremity orthoses, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94720","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50575","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11950","name":"Subq njx filling matrl 1cc/<","description":"Subcutaneous injection of filling material (eg, collagen); 1 cc or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","name":"Anes/analg cs dlvr neuraxial","description":"Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64771","name":"Sever cranial nerve","description":"Transection or avulsion of other cranial nerve, extradural","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21344","name":"Open tx compl front sinus fx","description":"Open treatment of complicated (eg, comminuted or involving posterior wall) frontal sinus fracture, via coronal or multiple approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55535","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61875","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10737.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64761","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21123","name":"Geniop sldg augmentation","description":"Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","name":"Anes all px nrv musc upr leg","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33983","name":"Replace vad intra w/bp","description":"Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2019.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76979","name":"Us trgt dyn mbubb ea addl","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92627","name":"Eval aud funcj ea addl 15","description":"Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64455","name":"Njx aa&/strd pltr com dg nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; plantar common digital nerve(s) (eg, mortons neuroma)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24340","name":"Tenodesis biceps tdn at elbw","description":"Tenodesis of biceps tendon at elbow (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61864","name":"Implant neuroelectrde addl","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; each additional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9500","name":"Tc99m sestamibi","description":"Technetium tc-99m sestamibi, diagnostic, per study dose","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42800","name":"Biopsy of throat","description":"Biopsy; oropharynx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61796","name":"Srs cranial lesion simple","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44603","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1341.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77078","name":"Ct bone density axial","description":"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26160","name":"Remove tendon sheath lesion","description":"Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or finger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15730","name":"Mdfc flap w/prsrv vasc pedcl","description":"Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24802","name":"Arthrd elbow jt autog graft","description":"Arthrodesis, elbow joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96934","name":"Rcm img acquisj&i&r ea addl","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48510","name":"Drain pancreatic pseudocyst","description":"External drainage, pseudocyst of pancreas, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81306","name":"Nudt15 gene common variants","description":"Nudt15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2549.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":944.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75724","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28307","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft (other than first toe)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34705","name":"Evac rpr a-biiliac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77071","name":"Mnl appl strs jt radiography","description":"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40808","name":"Biopsy of mouth lesion","description":"Biopsy, vestibule of mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50576","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46210","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87046","name":"Stool cultr aerobic bact ea","description":"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20526","name":"Ther injection carp tunnel","description":"Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28045","name":"Exc foot/toe tum deep <1.5cm","description":"Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); less than 1.5 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69666","name":"Repair middle ear structures","description":"Repair oval window fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91065","name":"Breath hydrogen/methane test","description":"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33861","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2469.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15945","name":"Exc isch pr ulc skn flp ostc","description":"Excision, ischial pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28140","name":"Removal of metatarsal","description":"Metatarsectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87299","name":"Antibody detection nos if","description":"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90868","name":"Tcranial magn stim tx deli","description":"Therapeutic repetitive transcranial magnetic stimulation (tms) treatment; subsequent delivery and management, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86329","name":"Immunodiffusion nes","description":"Immunodiffusion; not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4090.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33981","name":"Replace vad pump ext","description":"Replacement of extracorporeal ventricular assist device, single or biventricular, pump(s), single or each pump","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64635","name":"Destroy lumb/sac facet jnt","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); lumbar or sacral, single facet joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57155","name":"Insert uteri tandem/ovoids","description":"Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59618","name":"Attempted vbac delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2108.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":771.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31647","name":"Bronchial valve init insert","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26916.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35306","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; each additional tibial or peroneal artery (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61680","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2062.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77002","name":"Needle localization by xray","description":"Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":691.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62350","name":"Implant spinal canal cath","description":"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85613","name":"Russell viper venom diluted","description":"Russell viper venom time (includes venom); diluted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78465","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28086","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; flexor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0277","name":"Hbot, full body chamber, 30m","description":"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64400","name":"Njx aa&/strd trigeminal nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67921","name":"Repair eyelid defect","description":"Repair of entropion; suture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28737","name":"Revision of foot bones","description":"Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, miller type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3656.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96450","name":"Chemotherapy into cns","description":"Chemotherapy administration, into cns (eg, intrathecal), requiring and including spinal puncture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75560","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78483","name":"Heart first pass multiple","description":"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58750","name":"Repair oviduct","description":"Tubotubal anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95065","name":"Dir nsl mucous membrane test","description":"Direct nasal mucous membrane test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31612","name":"Perq trchl pnxr ttrach aspir","description":"Tracheal puncture, percutaneous with transtracheal aspiration and/or injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KC"]},{"negotiated_type":"negotiated","negotiated_rate":4874.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64726","name":"Dcmprn plantar digital nerve","description":"Decompression; plantar digital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46916","name":"Cryosurgery anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15934","name":"Exc sacral pr ulc skn flap","description":"Excision, sacral pressure ulcer, with skin flap closure;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83887","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6014","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78801","name":"Rp loclzj tum 2+area 1+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or m","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2710.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68135","name":"Destruction les conjunctiva","description":"Destruction of lesion, conjunctiva","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75650","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21082","name":"Impres&prep paltl aug prosth","description":"Impression and custom preparation; palatal augmentation prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74301","name":"X-rays at surgery add-on","description":"Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92980","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78452","name":"Ht muscle image spect mult","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or red","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86658","name":"Enterovirus antibody","description":"Antibody; enterovirus (eg, coxsackie, echo, polio)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8387.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8424","name":"Ready gradient sleeve","description":"Gradient pressure aid (sleeve), ready made","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88121","name":"Cytp urine 3-5 probes cmptr","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92620","name":"Auditory function 60 min","description":"Evaluation of central auditory function, with report; initial 60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77421","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15847","name":"Exc skin abd add-on","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg, abdominoplasty) (includes umbilical transposition and fascial plication) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3799.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99463","name":"Same day nb discharge","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and discharged on the same date","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3912.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3485","name":"Shoe heel pad removable for","description":"Heel, pad, removable for spur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98928","name":"Osteopath manj 7-8 regions","description":"Osteopathic manipulative treatment (omt); 7-8 body regions involved","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6549","name":"Grad com garm noc day use","description":"Gradient compression garment, not otherwise specified, for daytime use, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11421","name":"Exc h-f-nk-sp b9+marg 0.6-1","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78464","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69661","name":"Revise middle ear bone","description":"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86005","name":"Allg spec ige multiallg scr","description":"Allergen specific ige; qualitative, multiallergen screen (eg, disk, sponge, card)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87622","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17463.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","name":"Anes art sho&ax ax-fem bpg","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21421","name":"Cltx palatal/max fx wire fix","description":"Closed treatment of palatal or maxillary fracture (lefort i type), with interdental wire fixation or fixation of denture or splint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43761","name":"Reposition gastrostomy tube","description":"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2718.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92315","name":"C-lens fitg tech aphakia 1","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, 1 eye","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6007","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54304","name":"Revision of penis","description":"Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92565","name":"Stenger test pure tone","description":"Stenger test, pure tone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46751","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; child","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1768.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36833","name":"Av fistula revision","description":"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72149","name":"Mri lumbar spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91065","name":"Breath hydrogen/methane test","description":"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92352","name":"Fit aphakia spectcl monofocl","description":"Fitting of spectacle prosthesis for aphakia; monofocal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28270","name":"Release of foot contracture","description":"Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49010","name":"Exploration behind abdomen","description":"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4813.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40818","name":"Excise oral mucosa for graft","description":"Excision of mucosa of vestibule of mouth as donor graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0118","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47500","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90476","name":"Adenovirus vaccine type 4","description":"Adenovirus vaccine, type 4, live, for oral use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69550","name":"Exc aurl glomus tum trnscanl","description":"Excision aural glomus tumor; transcanal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99606","name":"Mtms by pharm est 15 min","description":"Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; initial 15 minutes, established patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26952","name":"Amputation of finger/thumb","description":"Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with local advancement flaps (v-y, hood)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33275","name":"Tcat rmvl perm ldls pm w/img","description":"Transcatheter removal of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","name":"Anes xtrprtl lwr abd rnl px","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67312","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 horizontal muscles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78459","name":"Myocrd img pet single study","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23120","name":"Claviculectomy partial","description":"Claviculectomy; partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33615","name":"Repair modified fontan","description":"Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulmonary artery (simple fontan procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1735.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93641","name":"Ep evl 1/2chmb pac cvdfb tst","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23485","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation; with bone graft for nonunion or malunion (includes obtaining graft and/or necessary fixation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43847","name":"Gstr rstcv px sm int rcnstj","description":"Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74363","name":"X-ray bile duct dilation","description":"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0245T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27637","name":"Remove/graft leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula; with autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32486","name":"Sleeve lobectomy","description":"Removal of lung, other than pneumonectomy; with circumferential resection of segment of bronchus followed by broncho-bronchial anastomosis (sleeve lobectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1887.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65810","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88367","name":"Insitu hybridization auto","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70557","name":"Mri brain w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75994","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86612","name":"Blastomyces antibody","description":"Antibody; blastomyces","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88334","name":"Path consltj surg cyto xm ea","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19357","name":"Tiss xpndr plmt brst rcnstj","description":"Tissue expander placement in breast reconstruction, including subsequent expansion(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":964.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97161","name":"Pt eval low complex 20 min","description":"Physical therapy evaluation: low complexity, requiring these components: a history with no personal factors and/or comorbidities that impact the plan of care; an examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84255","name":"Assay of selenium","description":"Selenium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88241","name":"Frozen cell preparation","description":"Thawing and expansion of frozen cells, each aliquot","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23473","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1370.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87207","name":"Smear special stain","description":"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64646","name":"Chemodenerv trunk musc 1-5","description":"Chemodenervation of trunk muscle(s); 1-5 muscle(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87449","name":"Nos each organism ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; not otherwise specified, each organism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80156","name":"Assay carbamazepine total","description":"Carbamazepine; total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73719","name":"Mri lower extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21930","name":"Exc back les sc < 3 cm","description":"Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93279","name":"Prgrmg dev eval pm/ldls pm","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system or","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47554","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with removal of calculus/calculi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82952","name":"Gtt-added samples","description":"Glucose; tolerance test, each additional beyond 3 specimens (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4367.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29892","name":"Arthrs aid rpr od les/tib fx","description":"Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87285","name":"Treponema pallidum ag if","description":"Infectious agent antigen detection by immunofluorescent technique; treponema pallidum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0310","name":"Immunize counsel 5-15 min","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4485.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92640","name":"Aud brainstem implt programg","description":"Diagnostic analysis with programming of auditory brainstem implant, per hour","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33927","name":"Impltj tot rplcmt hrt sys","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2232.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8902","name":"Mra w/o fol w/cont, abd","description":"Magnetic resonance angiography without contrast followed by with contrast, abdomen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97598","name":"Dbrdmt opn wnd addl 20cm/<","description":"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when perform","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27758","name":"Treatment of tibia fracture","description":"Open treatment of tibial shaft fracture (with or without fibular fracture), with plate/screws, with or without cerclage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402T","name":"Colgn crs-link crn&pachymtry","description":"Collagen cross-linking of cornea, including removal of the corneal epithelium, when performed, and intraoperative pachymetry, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74175","name":"Cta abdomen w/contrast","description":"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95920","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49407","name":"Image cath fluid trns/vgnl","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86705","name":"Hep b core antibody igm","description":"Hepatitis b core antibody (hbcab); igm antibody","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0514","name":"Prolong prev svcs, addl 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventi","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33973","name":"Insert balloon device","description":"Insertion of intra-aortic balloon assist device through the ascending aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70558","name":"Mri brain w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64625","name":"Rf abltj nrv nrvtg si jt","description":"Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92019","name":"Lmtd oph exam general anes","description":"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82441","name":"Test for chlorohydrocarbons","description":"Chlorinated hydrocarbons, screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58820","name":"Drain ovary abscess open","description":"Drainage of ovarian abscess; vaginal approach, open","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62319","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23415","name":"Release of shoulder ligament","description":"Coracoacromial ligament release, with or without acromioplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50327","name":"Prep renal graft/venous","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2515.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93571","name":"Iv dop vel&/press c flo 1st","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; initial vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38243","name":"Transplj hematopoietic boost","description":"Hematopoietic progenitor cell (hpc); hpc boost","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35650","name":"Bpg axillary-axillary","description":"Bypass graft, with other than vein; axillary-axillary","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57505","name":"Endocervical curettage","description":"Endocervical curettage (not done as part of a dilation and curettage)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2591.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78835","name":"Rp quan meas single area","description":"Radiopharmaceutical quantification measurement(s) single area (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"Office o/p est mod 30 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L2770","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31375","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); laterovertical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19083","name":"Bx breast 1st lesion us imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ultrasound guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27381","name":"Repair/graft kneecap tendon","description":"Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3208","name":"Surgical boot each infant","description":"Surgical boot, each, infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44383","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17264","name":"Dstrj mal les t/a/l 3.1-4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54437","name":"Repair corporeal tear","description":"Repair of traumatic corporeal tear(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17271","name":"Dstr mal les s/n/h/f/g 0.6-1","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43600","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64714","name":"Revise low back nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78122","name":"Whl bld volume determination","description":"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31545","name":"Remove vc lesion w/scope","description":"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local tissue flap(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51705","name":"Change of bladder tube","description":"Change of cystostomy tube; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00942","name":"Anes vag px clptmy vgnc clpr","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); colpotomy, vaginectomy, colporrhaphy, and open urethral procedures","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29583","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86329","name":"Immunodiffusion nes","description":"Immunodiffusion; not elsewhere specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35701","name":"Expl n/flwd surg neck art","description":"Exploration not followed by surgical repair, artery; neck (eg, carotid, subclavian)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48520","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82657","name":"Enzyme cell activity","description":"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17266","name":"Dstrj mal les t/a/l >4.0 cm","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter over 4.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","KM","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15157","name":"Tis clt agrft f/s/n/h/f/g ea","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21247","name":"Reconstruct lower jaw bone","description":"Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64714","name":"Revise low back nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84305","name":"Assay of somatomedin","description":"Somatomedin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","name":"Anes integ sys rcnstv breast","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps)","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6402.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63173","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","name":"Anes ther ivntl rad artl nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61591","name":"Infratemporal approach/skull","description":"Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resection of sigmoid sinus, with or without decompression and/or mobilization of contents of auditory cana","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2611.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82492","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88172","name":"Cytp dx eval fna 1st ea site","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47560","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55500","name":"Removal of hydrocele","description":"Excision of hydrocele of spermatic cord, unilateral (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80416","name":"Renin stimulation panel","description":"Renal vein renin stimulation panel (eg, captopril) this panel must include the following: renin (84244 x 6)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47564","name":"Laparo cholecystectomy/explr","description":"Laparoscopy, surgical; cholecystectomy with exploration of common duct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86300","name":"Immunoassay tumor ca 15-3","description":"Immunoassay for tumor antigen, quantitative; ca 15-3 (27.29)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32653","name":"Thoracoscopy remov fb/fibrin","description":"Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57265","name":"Cmbn ap colprhy w/ntrcl rpr","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP22","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42205","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75945","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51100","name":"Drain bladder by needle","description":"Aspiration of bladder; by needle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A7042","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35549","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3384.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51980","name":"Construct bladder opening","description":"Cutaneous vesicostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":976.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65920","name":"Remove implant of eye","description":"Removal of implanted material, anterior segment of eye","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","name":"Anes th ivnt rad ntrthrc/jug","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75959","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3211","name":"Surgical boot each junior","description":"Surgical boot, each, junior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74330","name":"X-ray bile/panc endoscopy","description":"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00561","name":"Anes px heart w/pump<1 yr","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year of age","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","name":"Anes opn px upr tib fib&/pat","description":"Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47505","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67820","name":"Revise eyelashes","description":"Correction of trichiasis; epilation, by forceps only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4855.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77408","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87580","name":"M.pneumon dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00528","name":"Anes clsd ch mediast&thrc wo","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23625","name":"Cltx gr hmrl tbrs fx w/mnpj","description":"Closed treatment of greater humeral tuberosity fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3891","name":"Torsion mechanism wrist/elbo","description":"Addition to upper extremity joint, wrist or elbow, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29515","name":"Application short leg splint","description":"Application of short leg splint (calf to foot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4161","name":"Ef ped hydrolyzed/amino acid","description":"Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35082","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1923.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55842","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":948.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93975","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88367","name":"Insitu hybridization auto","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50548","name":"Laparo remove w/ureter","description":"Laparoscopy, surgical; nephrectomy with total ureterectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1089.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43648","name":"Lap revise/remv eltrd antrum","description":"Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32140","name":"Removal of lung lesion(s)","description":"Thoracotomy; with cyst(s) removal, includes pleural procedure when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1639.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0433","name":"Elisa hiv-1/hiv-2 screen","description":"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2250","name":"Remot img sub by pt, non e/m","description":"Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or p","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82759","name":"Assay of rbc galactokinase","description":"Galactokinase, rbc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96921","name":"Excimer lsr psriasis 250-500","description":"Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24105","name":"Excision olecranon bursa","description":"Excision, olecranon bursa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","name":"Emergency dept visit hi mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22548","name":"Arthrd ant toral/xoral c1-c2","description":"Arthrodesis, anterior transoral or extraoral technique, clivus-c1-c2 (atlas-axis), with or without excision of odontoid process","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28297","name":"Cor hlx vlgs jt arthrd","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75900","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33330","name":"Insert major vessel graft","description":"Insertion of graft, aorta or great vessels; without shunt, or cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1234.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77432","name":"Stereotactic radiation trmt","description":"Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67312","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 horizontal muscles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2500.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0199","name":"Med abortion inc all ex drug","description":"Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0042T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78135","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","name":"Anes all px nrv musc upr leg","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","name":"Anes opn/arthr tot sho rplcm","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28345","name":"Repair webbed toe(s)","description":"Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92612","name":"Endoscopy swallow (fees) vid","description":"Flexible endoscopic evaluation of swallowing by cine or video recording;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22810","name":"Arthrd ant dfrm 4-7 vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1812.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63662","name":"Remove spine eltrd plate","description":"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KF"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4347.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64744","name":"Incise nerve back of head","description":"Transection or avulsion of; greater occipital nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3656.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36568","name":"Insj picc <5 yr w/o imaging","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, without imaging guidance; younger than 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99217","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87188","name":"Sc std macrobroth dil meth","description":"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92609","name":"Use of speech device service","description":"Therapeutic services for the use of speech-generating device, including programming and modification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95982","name":"Io ga n-stim subsq w/reprog","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; s","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27625","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42971","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36568","name":"Insj picc <5 yr w/o imaging","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, without imaging guidance; younger than 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76150","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87276","name":"Influenza a ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza a virus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92960","name":"Cardioversion electric ext","description":"Cardioversion, elective, electrical conversion of arrhythmia; external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87332","name":"Cytomegalovirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cytomegalovirus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97139","name":"Unlisted therapeutic px","description":"Unlisted therapeutic procedure (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96373","name":"Ther/proph/diag inj ia","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intra-arterial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29907","name":"Subtalar arthro w/fusion","description":"Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32501","name":"Repair bronchus add-on","description":"Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19105","name":"Cryosurg ablate fa each","description":"Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each fibroadenoma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38770","name":"Remove pelvis lymph nodes","description":"Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1639.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64716","name":"Revision of cranial nerve","description":"Neuroplasty and/or transposition; cranial nerve (specify)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1913.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":149.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20560","name":"Ndl insj w/o njx 1 or 2 musc","description":"Needle insertion(s) without injection(s); 1 or 2 muscle(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1154.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97610","name":"Low frequency non-thermal us","description":"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60600","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; without excision of carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1185.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28496","name":"Treat big toe fracture","description":"Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49420","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","QB","NU","QF","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33413","name":"Replacement of aortic valve","description":"Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (ross procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2813.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1396.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":735.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92060","name":"Sensorimotor examination","description":"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55650","name":"Remove sperm duct pouch","description":"Vesiculectomy, any approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87541","name":"Legion pneumo dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25275","name":"Repair forearm tendon sheath","description":"Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor carpi ulnaris subluxation)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4801.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32669","name":"Thoracoscopy remove segment","description":"Thoracoscopy, surgical; with removal of a single lung segment (segmentectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1075.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26746","name":"Treat finger fracture each","description":"Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, includes internal fixation, when performed, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82930","name":"Gastric analy w/ph ea spec","description":"Gastric acid analysis, includes ph if performed, each specimen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40830","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; 2.5 cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49460","name":"Fix g/colon tube w/device","description":"Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including contrast injection(s), if performed, image documentation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10030","name":"Img gid flu coll drg sft tis","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92202","name":"Opscpy extnd on/mac draw","description":"Ophthalmoscopy, extended; with drawing of optic nerve or macula (eg, for glaucoma, macular pathology, tumor) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72130","name":"Ct chest spine w/o & w/dye","description":"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95922","name":"Autonomic nrv adrenrg inervj","description":"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30117","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; internal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93619","name":"Comprehensive ep evaluation","description":"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; office type procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0340","name":"Robt lin-radsurg fractx 2-5","description":"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2012.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP07","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0320","name":"Two-way audio and video hhs","description":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76979","name":"Us trgt dyn mbubb ea addl","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92597","name":"Oral speech device eval","description":"Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59510","name":"Cesarean delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21030","name":"Excise max/zygoma b9 tumor","description":"Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3203","name":"Oxford w/ supinator/pronator","description":"Orthopedic shoe, oxford with supinator or pronator, junior","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76145","name":"Med physic dos eval rad exps","description":"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27091","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1354.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58800","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84127","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33922","name":"Transect pulmonary artery","description":"Transection of pulmonary artery with cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95977","name":"Alys cplx cn npgt prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39421.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2204.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20805","name":"Replant forearm complete","description":"Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2782.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68761","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by plug, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99191","name":"Special pump services","description":"Assembly and operation of pump with oxygenator or heat exchanger (with or without ecg and/or pressure monitoring); 45 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43275","name":"Ercp remove forgn body duct","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3213.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86904","name":"Blood typing patient serum","description":"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71040","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93529","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53020","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); except infant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61546","name":"Removal of pituitary gland","description":"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2118.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27111","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to femoral neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45334","name":"Sigmoidoscopy for bleeding","description":"Sigmoidoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73219","name":"Mri upper extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84234","name":"Assay of progesterone","description":"Receptor assay; progesterone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45307","name":"Proctosigmoidoscopy fb","description":"Proctosigmoidoscopy, rigid; with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42227","name":"Lengthening of palate","description":"Lengthening of palate, with island flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93455","name":"Coronary art/grft angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":57.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42107","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with local flap closure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5199.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27427","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; extra-articular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75902","name":"Remove cva lumen obstruct","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41015","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25230","name":"Partial removal of radius","description":"Radial styloidectomy (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64480","name":"Njx aa&/strd tfrm epi c/t ea","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), cervical or thoracic, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35302","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; superficial femoral artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":979.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99175","name":"Induction of vomiting","description":"Ipecac or similar administration for individual emesis and continued observation until stomach adequately emptied of poison","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29834","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; with removal of loose body or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75984","name":"Xray control catheter change","description":"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","name":"Anes all px nrv musc upr leg","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21048","name":"Remove maxilla cyst complex","description":"Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90814","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2474.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44213","name":"Lap mobil splenic fl add-on","description":"Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92004","name":"Compre oph exam new pt 1/>","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73523","name":"X-ray exam hips bi 5/> views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1520","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1384.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31577","name":"Largsc w/rmvl foreign bdy(s)","description":"Laryngoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12021","name":"Tx supfc wnd dehsn w/packing","description":"Treatment of superficial wound dehiscence; with packing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58900","name":"Biopsy of ovary(s)","description":"Biopsy of ovary, unilateral or bilateral (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54340","name":"Rpr hypspad comp simple","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23071","name":"Exc shoulder les sc 3 cm/>","description":"Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87482","name":"Candida dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27886","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; re-amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27500","name":"Treatment of thigh fracture","description":"Closed treatment of femoral shaft fracture, without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27691","name":"Revise lower leg tendon","description":"Transfer or transplant of single tendon (with muscle redirection or rerouting); deep (eg, anterior tibial or posterior tibial through interosseous space, flexor digitorum longus, flexor hallucis longus, or peroneal tendon to midfoot or hindfoot)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","name":"Anes all px nrv msc kne&/pop","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92132","name":"Cptrzd oph dx img ant sgm","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), anterior segment, with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33982","name":"Replace vad intra w/o bp","description":"Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1706.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87300","name":"Ag detection polyval if","description":"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AV","AU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":670.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36222","name":"Place cath carotid/inom art","description":"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85301","name":"Antithrombin iii antigen","description":"Clotting inhibitors or anticoagulants; antithrombin iii, antigen assay","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42220","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; secondary lengthening procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28208","name":"Repair of foot tendon","description":"Repair, tendon, extensor, foot; primary or secondary, each tendon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77772","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93297","name":"Rem interrog dev eval icpms","description":"Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors, analysis, review(s) and report(s) by a physician or other quali","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74241","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4580","name":"Cast supplies (plaster)","description":"Cast supplies (e.g., plaster)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85397","name":"Clotting funct activity","description":"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, adamts-13), each analyte","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44139","name":"Mobilization of colon","description":"Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (list separately in addition to primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3091.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94781","name":"Cars/bd tst inft-12mo +30min","description":"Car seat/bed testing for airway integrity, for infants through 12 months of age, with continual clinical staff observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; each additional full 30 minutes (list separately in addition to code","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45402","name":"Lap proctopexy w/sig resect","description":"Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33820","name":"Repair pda by ligation","description":"Repair of patent ductus arteriosus; by ligation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358T","name":"Bia whole body","description":"Bioelectrical impedance analysis whole body composition assessment, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68750","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565T","name":"Autol cell implt adps hrvg","description":"Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; tissue harvesting and cellular implant creation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27552","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; requiring anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52640","name":"Relieve bladder contracture","description":"Transurethral resection; of postoperative bladder neck contracture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75573","name":"Ct hrt c+ strux cgen hrt ds","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3d image postprocessing, assessment of left ventricular [lv] cardiac function, right ventricular [rv] structure and function and evaluation of ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0083","name":"Care man h v ext pt 45 m","description":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95927","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","name":"Anes cls px upr tib fib&/pat","description":"Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87850","name":"N. gonorrhoeae assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; neisseria gonorrhoeae","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64898","name":"Nrv grf mltst arm/leg >4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99082","name":"Unusual physician travel","description":"Unusual travel (eg, transportation and escort of patient)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64645","name":"Chemodenerv 1 extrem 5/> ea","description":"Chemodenervation of one extremity; each additional extremity, 5 or more muscles (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21495","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36557","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43846","name":"Gstr rstcv px shrt roux-en-y","description":"Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) roux-en-y gastroenterostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66984","name":"Xcapsl ctrc rmvl w/o ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92316","name":"C-lens fitg tech aphakia ou","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, both eyes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1549.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67825","name":"Revise eyelashes","description":"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21040","name":"Excise mandible lesion","description":"Excision of benign tumor or cyst of mandible, by enucleation and/or curettage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91035","name":"G-esoph reflx tst w/electrod","description":"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry ph electrode placement, recording, analysis and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9016","name":"Rbc leukocytes reduced","description":"Red blood cells, leukocytes reduced, each unit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21825","name":"Treat sternum fracture","description":"Open treatment of sternum fracture with or without skeletal fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46942","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); subsequent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5999","name":"Lowr extremity prosthes nos","description":"Lower extremity prosthesis, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86692","name":"Hepatitis delta agent antbdy","description":"Antibody; hepatitis, delta agent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4220","name":"Parenteral supply kit premix","description":"Parenteral nutrition supply kit; premix, per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29881","name":"Arthrs kne srg mnisectmy m/l","description":"Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36820","name":"Av fusion/forearm vein","description":"Arteriovenous anastomosis, open; by forearm vein transposition","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58520","name":"Repair of ruptured uterus","description":"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64494","name":"Inj paravert f jnt l/s 2 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86580","name":"Tb intradermal test","description":"Skin test; tuberculosis, intradermal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63685","name":"Ins/rplc spi npg/rcvr pocket","description":"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5577.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21423","name":"Optx palatal/max fx comp","description":"Open treatment of palatal or maxillary fracture (lefort i type); complicated (comminuted or involving cranial nerve foramina), multiple approaches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45905","name":"Dilation of anal sphincter","description":"Dilation of anal sphincter (separate procedure) under anesthesia other than local","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92973","name":"Prq trluml c mchn asp thrmbc","description":"Percutaneous transluminal coronary mechanical aspiration thrombectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28890","name":"Hi enrgy eswt plantar fascia","description":"Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39010","name":"Exploration of chest","description":"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; transthoracic approach, including either transthoracic or median sternotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36260","name":"Insertion of infusion pump","description":"Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82776","name":"Galactose transferase test","description":"Galactose-1-phosphate uridyl transferase; screen","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31574","name":"Largsc w/njx augmentation","description":"Laryngoscopy, flexible; with injection(s) for augmentation (eg, percutaneous, transoral), unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72141","name":"Mri neck spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46275","name":"Remove anal fist inter","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31661","name":"Bronch thermoplsty 2/> lobes","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41130","name":"Partial removal of tongue","description":"Glossectomy; hemiglossectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44121","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; each additional resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2205.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27725","name":"Repair of lower leg","description":"Repair of nonunion or malunion, tibia; by synostosis, with fibula, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66625","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35510","name":"Art byp grft carotid-brchial","description":"Bypass graft, with vein; carotid-brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19355","name":"Correct inverted nipple(s)","description":"Correction of inverted nipples","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6009","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62264","name":"Epidural lysis on single day","description":"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43112","name":"Esphg tot w/thrcm","description":"Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (ie, mckeown esophagectomy or tri-incisional esophagectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2907.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34101","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; axillary, brachial, innominate, subclavian artery, by arm incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78709","name":"K flow/funct image multiple","description":"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26535","name":"Revise finger joint","description":"Arthroplasty, interphalangeal joint; each joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2400.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12057","name":"Intmd rpr face/mm >30.0 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4931","name":"Reusable oral thermometer","description":"Oral thermometer, reusable, any type, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82528","name":"Assay of corticosterone","description":"Corticosterone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93745","name":"Set-up cardiovert-defibrill","description":"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ecg, transmission of data to data repository, patient instruction in wearing system and patient re","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4456.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55110","name":"Explore scrotum","description":"Scrotal exploration","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35490","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4350.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27441","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95803","name":"Actigraphy testing","description":"Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55535","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00326","name":"Anes all px larynx&trach<1yr","description":"Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57520","name":"Conization of cervix","description":"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36582","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same venous access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","name":"Anes male gent undscnd tstis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90885","name":"Psy evaluation of records","description":"Psychiatric evaluation of hospital records, other psychiatric reports, psychometric and/or projective tests, and other accumulated data for medical diagnostic purposes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57283","name":"Colpopexy intraperitoneal","description":"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50840","name":"Replace ureter by bowel","description":"Replacement of all or part of ureter by intestine segment, including intestine anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90814","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2657.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33860","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2703.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42425","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57107","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9516","name":"Iodine i-123 sod iodide mic","description":"Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36440","name":"Bld push tfuj 2 yr/<","description":"Push transfusion, blood, 2 years or younger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50684","name":"Injection for ureter x-ray","description":"Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43640","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":982.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4206","name":"1 cc sterile syringe&needle","description":"Syringe with needle, sterile, 1 cc or less, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01953","name":"Anes 2&3 burn ea add 9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; each additional 9% total body surface area or part thereof (list separately in addition to code for primary procedur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93724","name":"Elec alys antitchycar pm sys","description":"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87511","name":"Gardner vag dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17313","name":"Mohs 1 stage t/a/l","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25075","name":"Exc forearm les sc < 3 cm","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8244.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3842.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1317.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29851","name":"Knee arthroscopy/surgery","description":"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34804","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69000","name":"Drg xtrnl ear absc/hem smpl","description":"Drainage external ear, abscess or hematoma; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92603","name":"Cochlear implt f/up exam 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; with programming","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50225","name":"Removal kidney open complex","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23680","name":"Optx sho dislc neck fx fixj","description":"Open treatment of shoulder dislocation, with surgical or anatomical neck fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3822.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21245","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; partial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":967.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93289","name":"Interrog device eval heart","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including anal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96168","name":"Hlth bhv ivntj fam ea addl","description":"Health behavior intervention, family (with the patient present), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87106","name":"Fungi identification yeast","description":"Culture, fungi, definitive identification, each organism; yeast","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23180","name":"Prtl excision bone clavicle","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), clavicle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88332","name":"Path consltj surg ea add blk","description":"Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46910","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94005","name":"Home vent mgmt supervision","description":"Home ventilator management care plan oversight of a patient (patient not present) in home, domiciliary or rest home (eg, assisted living) requiring review of status, review of laboratories and other studies and revision of orders and respiratory care plan (as appropriate), within a calendar month, 3","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7523.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61519","name":"Remove brain lining lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2719.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29010","name":"Appl risser jacket body only","description":"Application of risser jacket, localizer, body; only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86741","name":"Neisseria meningitidis","description":"Antibody; neisseria meningitidis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58970","name":"Retrieval of oocyte","description":"Follicle puncture for oocyte retrieval, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92285","name":"External ocular photography","description":"External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62302","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2322.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0610","name":"Annual gynecological examina","description":"Annual gynecological examination, new patient","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1532.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","name":"Anes rad amp pns ingun&ilac","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92240","name":"Icg angiography i&r uni/bi","description":"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37615","name":"Ligation major artery neck","description":"Ligation, major artery (eg, post-traumatic, rupture); neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47530","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26596","name":"Excision constricting tissue","description":"Excision of constricting ring of finger, with multiple z-plasties","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1364.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20910","name":"Remove cartilage for graft","description":"Cartilage graft; costochondral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67105","name":"Repair detached retina pc","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26111","name":"Exc hand les sc 1.5 cm/>","description":"Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; 1.5 cm or greater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L2860","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48000","name":"Drainage of abdomen","description":"Placement of drains, peripancreatic, for acute pancreatitis;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1584.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0482","name":"Drug test def 15-21 classes","description":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding i","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78587","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54055","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65765","name":"Keratophakia","description":"Keratophakia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84586","name":"Assay of vip","description":"Vasoactive intestinal peptide (vip)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5429.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15770","name":"Derma-fat-fascia graft","description":"Graft; derma-fat-fascia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33548","name":"Restore/remodel ventricle","description":"Surgical ventricular restoration procedure, includes prosthetic patch, when performed (eg, ventricular remodeling, svr, saver, dor procedures)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86382","name":"Neutralization test viral","description":"Neutralization test, viral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33957","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517T","name":"Insj wcs lv both compnt pg","description":"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; both components of pulse generator (battery and transmitter) only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3375.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":2794.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78835","name":"Rp quan meas single area","description":"Radiopharmaceutical quantification measurement(s) single area (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87516","name":"Hepatitis b dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis b virus, amplified probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0341","name":"Percutaneous islet celltrans","description":"Percutaneous islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38760","name":"Remove groin lymph nodes","description":"Inguinofemoral lymphadenectomy, superficial, including cloquets node (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24665","name":"Optx radial head/neck fx","description":"Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90744","name":"Hepb vacc 3 dose ped/adol im","description":"Hepatitis b vaccine (hepb), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73702","name":"Ct lwr extremity w/o&w/dye","description":"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87176","name":"Tissue homogenization cultr","description":"Homogenization, tissue, for culture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3208.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32900","name":"Removal of rib(s)","description":"Resection of ribs, extrapleural, all stages","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64585","name":"Rev/rmv perph nstim eltrd ra","description":"Revision or removal of peripheral neurostimulator electrode array","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38222","name":"Dx bone marrow bx & aspir","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1082.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27358","name":"Remove femur lesion/fixation","description":"Excision or curettage of bone cyst or benign tumor of femur; with internal fixation (list in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15040","name":"Harvest cultured skin graft","description":"Harvest of skin for tissue cultured skin autograft, 100 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77767","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KC"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32940","name":"Revision of lung","description":"Pneumonolysis, extraperiosteal, including filling or packing procedures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61156","name":"Burr hol aspir hmtm/cst icer","description":"Burr hole(s); with aspiration of hematoma or cyst, intracerebral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28106","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","name":"Anes dx/ther nrv blk&inj prn","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21811","name":"Optx of rib fx w/fixj scope","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 1-3 ribs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26561","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps and grafts","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61514","name":"Crnec treph exc brn abs sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1744.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86635","name":"Coccidioides antibody","description":"Antibody; coccidioides","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8686","name":"Implt nrostm pls gen sng non","description":"Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4064.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"Init pm e/m new pat infant","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age youn","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3362.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65930","name":"Remove blood clot from eye","description":"Removal of blood clot, anterior segment of eye","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61595","name":"Transtemporal approach/skull","description":"Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2025.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99337","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64718","name":"Revise ulnar nerve at elbow","description":"Neuroplasty and/or transposition; ulnar nerve at elbow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86060","name":"Antistreptolysin o titer","description":"Antistreptolysin 0; titer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93540","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36810","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (scribner type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72147","name":"Mri chest spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88230","name":"Tissue culture lymphocyte","description":"Tissue culture for non-neoplastic disorders; lymphocyte","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31652","name":"Bronch ebus samplng 1/2 node","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62321","name":"Njx interlaminar crv/thrc","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy o","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33506","name":"Repair artery translocation","description":"Repair of anomalous coronary artery from pulmonary artery origin; by translocation from pulmonary artery to aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21172","name":"Rcnst supr-lat orb rm&lw fhd","description":"Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1899.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","name":"Anes lwr intst ndsc nos","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5783.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":4987.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29906","name":"Subtalar arthro w/deb","description":"Arthroscopy, subtalar joint, surgical; with debridement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87177","name":"Ova and parasites smears","description":"Ova and parasites, direct smears, concentration and identification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","name":"Anes nrv msc upr a&e tnplsty","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28022","name":"Exploration of foot joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27468","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47542","name":"Dilate biliary duct/ampulla","description":"Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each duct (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21029","name":"Contour of face bone lesion","description":"Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95886","name":"Musc test done w/n test comp","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0275","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82120","name":"Amines vaginal fluid qual","description":"Amines, vaginal fluid, qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40700","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81336","name":"Smn1 gene full gene sequence","description":"Smn1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28226","name":"Release of foot tendons","description":"Tenolysis, extensor, foot; multiple tendons","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35121","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, renal, or mesenteric artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1773.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99143","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59121","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24505","name":"Cltx humrl shft fx w/mnpj","description":"Closed treatment of humeral shaft fracture; with manipulation, with or without skeletal traction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2415.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32659","name":"Thoracoscopy w/sac drainage","description":"Thoracoscopy, surgical; with creation of pericardial window or partial resection of pericardial sac for drainage","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85270","name":"Clot factor xi pta","description":"Clotting; factor xi (pta)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0319","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42962","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64891","name":"Nrv grf 1strnd hnd/foot >4cm","description":"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78710","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20245","name":"Bone biopsy open deep","description":"Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21387","name":"Opn tx orbit fx combined","description":"Open treatment of orbital floor blowout fracture; combined approach","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85008","name":"Bl smear w/o diff wbc count","description":"Blood count; blood smear, microscopic examination without manual differential wbc count","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74330","name":"X-ray bile/panc endoscopy","description":"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25391","name":"Lengthen radius or ulna","description":"Osteoplasty, radius or ulna; lengthening with autograft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93965","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42000","name":"Drainage mouth roof lesion","description":"Drainage of abscess of palate, uvula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2182.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97530","name":"Therapeutic activities","description":"Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64893","name":"Nrv grf 1strnd arm/leg >4 cm","description":"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36440","name":"Bld push tfuj 2 yr/<","description":"Push transfusion, blood, 2 years or younger","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49255","name":"Removal of omentum","description":"Omentectomy, epiploectomy, resection of omentum (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01610","name":"Anes all px nrv musc sho&ax","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87905","name":"Ia nzmtc actv oth/thn virus","description":"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11040","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26556","name":"Toe joint transfer","description":"Transfer, free toe joint, with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2879.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1852.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50329","name":"Prep renal graft/ureteral","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64650","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; both axillae","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27606","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); general anesthesia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61521","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2943.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92549","name":"Cdp-sot 6 cond w/i&r mct&adt","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (mct) and adaptation test (adt)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49906","name":"Free omental flap microvasc","description":"Free omental flap with microvascular anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0392","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1348.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6233.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20692","name":"Appl mltpln uni ext fixj sys","description":"Application of a multiplane (pins or wires in more than 1 plane), unilateral, external fixation system (eg, ilizarov, monticelli type)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47141","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments ii, iii and iv)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3592.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27332","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial or lateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32998","name":"Ablate pulm tumor perq rf","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76983","name":"Use ea addl target lesion","description":"Ultrasound, elastography; each additional target lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","name":"Anes cls px upr tib fib&/pat","description":"Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50547","name":"Laparo removal donor kidney","description":"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1381.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11312","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44151","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, without proctectomy; with continent ileostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1807.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50431","name":"Njx px nfrosgrm &/urtrgrm","description":"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62220","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-atrial, -jugular, -auricular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76513","name":"Oph us dx ant sgm us uni/bi","description":"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) b-scan or high resolution biomicroscopy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25260","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99292","name":"Critical care addl 30 min","description":"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","name":"Anes px art lower leg nos","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7499","name":"Upper extremity prosthes nos","description":"Upper extremity prosthesis, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6747.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23620","name":"Cltx gr hmrl tbrs fx wo mnpj","description":"Closed treatment of greater humeral tuberosity fracture; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11828.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","KF","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0392","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82248","name":"Bilirubin direct","description":"Bilirubin; direct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4841.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36569","name":"Insj picc 5 yr+ w/o imaging","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, without imaging guidance; age 5 years or older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33010","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32652","name":"Thoracoscopy rem totl cortex","description":"Thoracoscopy, surgical; with total pulmonary decortication, including intrapleural pneumonolysis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1328.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19020","name":"Mastotomy expl drg absc dp","description":"Mastotomy with exploration or drainage of abscess, deep","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62323","name":"Njx interlaminar lmbr/sac","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluorosc","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76377","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27187","name":"Reinforce hip bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, femoral neck and proximal femur","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","name":"Anes dx/ther nrv blk&inj oth","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":85.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76376","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8680","name":"Implt neurostim elctr each","description":"Implantable neurostimulator electrode, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78480","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69711","name":"Remove/repair hearing aid","description":"Removal or repair of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74340","name":"X-ray guide for gi tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott), including multiple fluoroscopies and images, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72292","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85305","name":"Clot inhibit prot s total","description":"Clotting inhibitors or anticoagulants; protein s, total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32653","name":"Thoracoscopy remov fb/fibrin","description":"Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31296","name":"Nsl/sins ndsc surg frnt sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostium","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43261","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"U0003","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27327","name":"Exc thigh/knee les sc < 3 cm","description":"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93924","name":"Lwr xtr vasc stdy bilat","description":"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a st","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43842","name":"Gstr rstcv px v-banded gstp","description":"Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0130","name":"Single energy x-ray study","description":"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66983","name":"Cataract surg w/iol 1 stage","description":"Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56405","name":"I&d vulva/perineal abscess","description":"Incision and drainage of vulva or perineal abscess","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26494","name":"Hand tendon/muscle transfer","description":"Opponensplasty; hypothenar muscle transfer","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15365","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51980","name":"Construct bladder opening","description":"Cutaneous vesicostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64636","name":"Destroy l/s facet jnt addl","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); lumbar or sacral, each additional facet joint (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":59.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22804","name":"Arthrd pst dfrm 13+ vrt sgm","description":"Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2116.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43202","name":"Esophagoscopy flex biopsy","description":"Esophagoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26785","name":"Treat finger dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed, single","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27033","name":"Arthrt hip expl/rmv loose/fb","description":"Arthrotomy, hip, including exploration or removal of loose or foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25449","name":"Revj arthrp wrist joint","description":"Revision of arthroplasty, including removal of implant, wrist joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3332.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47534","name":"Plmt biliary drainage cath","description":"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77401","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4180","name":"Parenteral sol carb > 50%","description":"Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9481","name":"Remote e/m new pt 10mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furni","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3141.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36511","name":"Apheresis wbc","description":"Therapeutic apheresis; for white blood cells","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83012","name":"Assay of haptoglobins","description":"Haptoglobin; phenotypes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63280","name":"Bx/exc idrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1938.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41116","name":"Excision of mouth lesion","description":"Excision, lesion of floor of mouth","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78830","name":"Rp loclzj tum spect w/ct 1","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97034","name":"App mdlty 1+cntrst bth ea 15","description":"Application of a modality to 1 or more areas; contrast baths, each 15 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33619","name":"Repair single ventricle","description":"Repair of single ventricle with aortic outflow obstruction and aortic arch hypoplasia (hypoplastic left heart syndrome) (eg, norwood procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78431","name":"Myocrd img pet rst&strs ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53085","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; complicated","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0451","name":"Devlopment test interpt&rep","description":"Development testing, with interpretation and report, per standardized instrument form","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95921","name":"Autonomic nrv parasym inervj","description":"Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded r-r interval, valsalva ratio, and 30:15 ratio","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0400","name":"Home sleep test/type 4 porta","description":"Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45383","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25066","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82775","name":"Assay galactose transferase","description":"Galactose-1-phosphate uridyl transferase; quantitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95180","name":"Rapid desensitization","description":"Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0999","name":"Add to spinal orthosis nos","description":"Addition to spinal orthosis, not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15956","name":"Exc trchntr pr ulc prep flap","description":"Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77777","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27514","name":"Treatment of thigh fracture","description":"Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":820.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86155","name":"Chemotaxis assay","description":"Chemotaxis assay, specify method","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33824","name":"Repair pda div 18 yrs&older","description":"Repair of patent ductus arteriosus; by division, 18 years and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1022.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25671","name":"Perq skel fix rad/uln dislc","description":"Percutaneous skeletal fixation of distal radioulnar dislocation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28062","name":"Removal of foot fascia","description":"Fasciectomy, plantar fascia; radical (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75561","name":"Cardiac mri for morph w/dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93623","name":"Prgrmd stimj&pacg iv rx nfs","description":"Programmed stimulation and pacing after intravenous drug infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29868","name":"Meniscal trnspl knee w/scpe","description":"Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93621","name":"Comp ep evl l pac&rec c sins","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93294","name":"Rem interrog evl pm/ldls pm","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, or leadless pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93350","name":"Stress tte only","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4250","name":"Urine reagent strips/tablets","description":"Urine test or reagent strips or tablets (100 tablets or strips)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34421","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by leg incision","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2109.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37223","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67950","name":"Revision of eyelid","description":"Canthoplasty (reconstruction of canthus)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84022","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38530","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, internal mammary node(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","name":"Anes iper upr abd gstr px mo","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2749.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"Office o/p est hi 40 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4868.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2001","name":"Post d/c h vst new pt 20 m","description":"Brief (20 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33211","name":"Insert card electrodes dual","description":"Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92019","name":"Lmtd oph exam general anes","description":"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; limited","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87534","name":"Hiv-1 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27516","name":"Treat thigh fx growth plate","description":"Closed treatment of distal femoral epiphyseal separation; without manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","name":"Anes clsd ch mediast&thrc w/","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy utilizing 1 lung ventilation","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47715","name":"Excision of bile duct cyst","description":"Excision of choledochal cyst","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1115.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85597","name":"Phospholipid pltlt neutraliz","description":"Phospholipid neutralization; platelet","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21121","name":"Geniop sldg osteot 1","description":"Genioplasty; sliding osteotomy, single piece","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0517","name":"Remove drug implant","description":"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"Home/res vst new mod mdm 60","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31632","name":"Bronchoscopy/lung bx addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86486","name":"Skin test unlisted antign ea","description":"Skin test; unlisted antigen, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","name":"Anes rad amp pns ingun&ilac","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","name":"Anes upr gi ndsc px ercp","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ercp)","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4508.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96567","name":"Pdt dstr prmlg les skn","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69220","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67120","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; extraocular","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80400","name":"Acth stimulation panel","description":"Acth stimulation panel; for adrenal insufficiency this panel must include the following: cortisol (82533 x 2)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45337","name":"Sigmoidoscopy & decompress","description":"Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59051","name":"Fetal monitor/interpret only","description":"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33875","name":"Thoracic aortic graft","description":"Descending thoracic aorta graft, with or without bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2394.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52270","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; female","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87660","name":"Trichomonas vagin dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, direct probe technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0244","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61557","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; bifrontal bone flap","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","26","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35184","name":"Rpr cgen av fistula xtr","description":"Repair, congenital arteriovenous fistula; extremities","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14020","name":"Tis trnfr s/a/l 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58548","name":"Lap radical hyst","description":"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1194.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74170","name":"Ct abd wo cntrst flwd cntrst","description":"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33920","name":"Repair pulmonary atresia","description":"Repair of pulmonary atresia with ventricular septal defect, by construction or replacement of conduit from right or left ventricle to pulmonary artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54861","name":"Removal of epididymis","description":"Epididymectomy; bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81343","name":"Ppp2r2b gen detc abnor allel","description":"Ppp2r2b (protein phosphatase 2 regulatory subunit bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":643.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":221.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55875","name":"Transperi needle place pros","description":"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91110","name":"Gi trc img intral esoph-ile","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73503","name":"X-ray exam hip uni 4/> views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42650","name":"Dilation of salivary duct","description":"Dilation salivary duct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66500","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); except transfixion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43634","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with formation of intestinal pouch","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1788.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43214","name":"Esophagosc dilate balloon 30","description":"Esophagoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65273","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23035","name":"Incision bone cortex sho","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), shoulder area","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7239.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3814.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29015","name":"Appl rissr jacket bdy w/head","description":"Application of risser jacket, localizer, body; including head","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15040","name":"Harvest cultured skin graft","description":"Harvest of skin for tissue cultured skin autograft, 100 sq cm or less","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21235","name":"Ear cartilage graft","description":"Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82543","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01470","name":"Anes px nrv msc lw l/a/f nos","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58752","name":"Revise ovarian tube(s)","description":"Tubouterine implantation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28250","name":"Revision of foot fascia","description":"Division of plantar fascia and muscle (eg, steindler stripping) (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0246T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67550","name":"Insert eye socket implant","description":"Orbital implant (implant outside muscle cone); insertion","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22212","name":"Incis 1 vertebral seg thorac","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80306","name":"Drug test prsmv instrmnt","description":"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72194","name":"Ct pelvis w/o & w/dye","description":"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83662","name":"Foam stability fetal lung","description":"Fetal lung maturity assessment; foam stability test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90675","name":"Rabies vaccine im","description":"Rabies vaccine, for intramuscular use","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0014","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; ambulatory detoxification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01953","name":"Anes 2&3 burn ea add 9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; each additional 9% total body surface area or part thereof (list separately in addition to code for primary procedur","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75630","name":"X-ray aorta leg arteries","description":"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34706","name":"Evasc rpr a-biiliac rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2026.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35351","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliac","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64622","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93982","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01520","name":"Anes px veins lower leg nos","description":"Anesthesia for procedures on veins of lower leg; not otherwise specified","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78434","name":"Aqmbf pet rest & rx stress","description":"Absolute quantitation of myocardial blood flow (aqmbf), positron emission tomography (pet), rest and pharmacologic stress (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93668","name":"Peripheral vascular rehab","description":"Peripheral arterial disease (pad) rehabilitation, per session","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52276","name":"Cystoscopy and treatment","description":"Cystourethroscopy with direct vision internal urethrotomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11970","name":"Rplcmt tiss xpndr perm implt","description":"Replacement of tissue expander with permanent implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","name":"Anes male gent compl amp pns","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); complete amputation of penis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73722","name":"Mri joint of lwr extr w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84597","name":"Assay of vitamin k","description":"Vitamin k","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95886","name":"Musc test done w/n test comp","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62328","name":"Dx lmbr spi pnxr w/fluor/ct","description":"Spinal puncture, lumbar, diagnostic; with fluoroscopic or ct guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48154","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2441.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28805","name":"Amputation thru metatarsal","description":"Amputation, foot; transmetatarsal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28445","name":"Optx talus fracture","description":"Open treatment of talus fracture, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28405","name":"Cltx calcaneal fx w/mnpj","description":"Closed treatment of calcaneal fracture; with manipulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2809.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":6932.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95885","name":"Musc tst done w/nerv tst lim","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22112","name":"Remove part thorax vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; thoracic","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93656","name":"Compre ep eval abltj atr fib","description":"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including left or right atrial pacing/recording, and intracardiac catheter ablation of atrial fibrillation by ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1199.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"Esrd srv 4 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88307","name":"Tissue exam by pathologist","description":"Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partia","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1809.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74301","name":"X-rays at surgery add-on","description":"Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":61.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47564","name":"Laparo cholecystectomy/explr","description":"Laparoscopy, surgical; cholecystectomy with exploration of common duct","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87905","name":"Ia nzmtc actv oth/thn virus","description":"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28341","name":"Resect enlarged toe","description":"Reconstruction, toe, macrodactyly; requiring bone resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98972","name":"Nqhp ol dig assmt&mgmt 21+","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["GP","GN","GO"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67938","name":"Remove eyelid foreign body","description":"Removal of embedded foreign body, eyelid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86316","name":"Immunoassay tumor other","description":"Immunoassay for tumor antigen, other antigen, quantitative (eg, ca 50, 72-4, 549), each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-09-01","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1390.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64912","name":"Nrv rpr w/nrv algrft 1st","description":"Nerve repair; with nerve allograft, each nerve, first strand (cable)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27792","name":"Treatment of ankle fracture","description":"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21145","name":"Rcnstj mdfc lefort i 1 w/grf","description":"Reconstruction midface, lefort i; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56632","name":"Vlvctmy rad prtl bi lymphad","description":"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1148.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31635","name":"Bronchoscopy w/fb removal","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21080","name":"Impres&prep def obt prosth","description":"Impression and custom preparation; definitive obturator prosthesis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1381.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67445","name":"Explr/decompress eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of bone for decompression","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35246","name":"Rpr blvsl vn grf ntrthrc w/o","description":"Repair blood vessel with vein graft; intrathoracic, without bypass","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","name":"Anes px vn knee&pop av fstl","description":"Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33986","name":"Ecmo/ecls rmvl ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, 6 years and older","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25915","name":"Amputation of forearm","description":"Krukenberg procedure","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63300","name":"Remove vert xdrl body crvcl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1658.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86340","name":"Intrinsic factor antibody","description":"Intrinsic factor antibodies","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28740","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, single joint","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94760","name":"N-invas ear/pls oximetry 1","description":"Noninvasive ear or pulse oximetry for oxygen saturation; single determination","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93286","name":"Peri-px eval pm/ldls pm ip","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead pacemaker system, or leadless pacemaker ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1887.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20808","name":"Replantation hand complete","description":"Replantation, hand (includes hand through metacarpophalangeal joints), complete amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68371","name":"Harvest eye tissue alograft","description":"Harvesting conjunctival allograft, living donor","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":62.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63066","name":"Decompress spine cord add-on","description":"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00326","name":"Anes all px larynx&trach<1yr","description":"Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33506","name":"Repair artery translocation","description":"Repair of anomalous coronary artery from pulmonary artery origin; by translocation from pulmonary artery to aorta","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36479","name":"Endovenous laser vein addon","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28102","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76496","name":"Unlisted fluoroscopic px","description":"Unlisted fluoroscopic procedure (eg, diagnostic, interventional)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28280","name":"Fusion of toes","description":"Syndactylization, toes (eg, webbing or kelikian type procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67145","name":"Proph rta dtchmnt pc","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33927","name":"Impltj tot rplcmt hrt sys","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2232.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62268","name":"Drain spinal cord cyst","description":"Percutaneous aspiration, spinal cord cyst or syrinx","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94619","name":"Exercise tst brncspsm wo ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; without electrocardiographic recording(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5646.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93922","name":"Upr/l xtremity art 2 levels","description":"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waveform recording and analysis at 1-2 levels, or ankle/brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62147","name":"Crnop w/autograft>5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1276.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29049","name":"Appl cast figure-of-eight","description":"Application, cast; figure-of-eight","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93286","name":"Peri-px eval pm/ldls pm ip","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead pacemaker system, or leadless pacemaker ","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58545","name":"Laparoscopic myomectomy","description":"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28585","name":"Repair foot dislocation","description":"Open treatment of talotarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87339","name":"H pylori ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; helicobacter pylori","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40804","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67902","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93458","name":"L hrt artery/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62287","name":"Dcmprn pq nuc pul 1/mlt lmbr","description":"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with discography and/or epidural injection(s) at the treated level(s), when performed, sing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","name":"Anes thrcm px trach&bronchi","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea and bronchi","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35321","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; axillary-brachial","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15828","name":"Rhytidectomy cheek chn & nck","description":"Rhytidectomy; cheek, chin, and neck","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3365.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1811.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0080","name":"Care manag h vst new pt 75 m","description":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72146","name":"Mri chest spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43257","name":"Egd w/thrml txmnt gerd","description":"Esophagogastroduodenoscopy, flexible, transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26587","name":"Reconstruct extra finger","description":"Reconstruction of polydactylous digit, soft tissue and bone","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43800","name":"Pyloroplasty","description":"Pyloroplasty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0393","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34808","name":"Endovas iliac a device addon","description":"Endovascular placement of iliac artery occlusion device (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84119","name":"Test urine for porphyrins","description":"Porphyrins, urine; qualitative","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33963","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11008","name":"Rmv prstc mtrl/mesh abd wall","description":"Removal of prosthetic material or mesh, abdominal wall for infection (eg, for chronic or recurrent mesh infection or necrotizing soft tissue infection) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80192","name":"Assay of procainamide","description":"Procainamide; with metabolites (eg, n-acetyl procainamide)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P3001","name":"Screening pap smear by phys","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84430","name":"Assay of thiocyanate","description":"Thiocyanate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99326","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82331","name":"Calcium infusion test","description":"Calcium; after calcium infusion test","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25151","name":"Partial removal of radius","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2595.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55175","name":"Revision of scrotum","description":"Scrotoplasty; simple","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61510","name":"Crnec treph exc brn tum sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2004.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497T","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15115","name":"Epdrm agrft f/s/n/h/f/g/m 1","description":"Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54550","name":"Exploration for testis","description":"Exploration for undescended testis (inguinal or scrotal area)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31546","name":"Remove vc lesion scope/graft","description":"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with graft(s) (includes obtaining autograft)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31633","name":"Bronchoscopy/needle bx addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82785","name":"Assay of ige","description":"Gammaglobulin (immunoglobulin); ige","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96361","name":"Hydrate iv infusion add-on","description":"Intravenous infusion, hydration; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24545","name":"Optx hum fx wo ntrcndylr xtn","description":"Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; without intercondylar extension","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37242","name":"Vasc embolize/occlude artery","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, other than hemorrhage or tumor (eg, congenital or acquired arterial malformations, arteriovenous malfo","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67228","name":"Treatment x10sv retinopathy","description":"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99282","name":"Emergency dept visit sf mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46754","name":"Removal of suture from anus","description":"Removal of thiersch wire or suture, anal canal","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4098","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76513","name":"Oph us dx ant sgm us uni/bi","description":"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) b-scan or high resolution biomicroscopy, unilateral or bilateral","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19283","name":"Perq dev breast 1st strtctc","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including stereotactic guidance","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20550","name":"Njx 1 tendon sheath/ligament","description":"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64492","name":"Inj paravert f jnt c/t 3 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; third and any additional level(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92285","name":"External ocular photography","description":"External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38100","name":"Removal of spleen total","description":"Splenectomy; total (separate procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58558","name":"Hysteroscopy biopsy","description":"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73219","name":"Mri upper extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"Prev visit new age 5-11","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60260","name":"Repeat thyroid surgery","description":"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01272","name":"Anes px art femoral art lig","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery ligation","date_of_service":"2026-09-01","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36471","name":"Njx sclrsnt mlt incmptnt vn","description":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95940","name":"Ionm in operatng room 15 min","description":"Continuous intraoperative neurophysiology monitoring in the operating room, one on one monitoring requiring personal attendance, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35694","name":"Art trnsposj subclav carotid","description":"Transposition and/or reimplantation; subclavian to carotid artery","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61619","name":"Repair dura","description":"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneous flap (including galea, temporalis, frontalis or occipitalis muscle)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95719","name":"Eeg phys/qhp ea incr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of eeg recording, interpretation and report after each 24-hour period; w","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50815","name":"Urine shunt to intestine","description":"Ureterocolon conduit, including intestine anastomosis","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88333","name":"Path consltj surg cyto xm 1","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21182","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting less than 40 sq cm","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43305","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24343","name":"Repr elbow lat ligmnt w/tiss","description":"Repair lateral collateral ligament, elbow, with local tissue","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87552","name":"Mycobacteria dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, quantification","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1731.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65175","name":"Removal of ocular implant","description":"Removal of ocular implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"Family psytx w/o pt 50 min","description":"Family psychotherapy (without the patient present), 50 minutes","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63198","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1914.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61630","name":"Balo angioplasty icr perq","description":"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54125","name":"Removal of penis","description":"Amputation of penis; complete","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84430","name":"Assay of thiocyanate","description":"Thiocyanate","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51020","name":"Cystotomy/cystostomy w/fulg","description":"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76813","name":"Ob us nuchal meas 1 gest","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23800","name":"Arthrodesis glenohumeral jt","description":"Arthrodesis, glenohumeral joint;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","name":"Anes px art fem art emblc","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery embolectomy","date_of_service":"2026-09-01","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01820","name":"Anes clsd px rds u/w/h bones","description":"Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77785","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"Psytx w pt w e/m 30 min","description":"Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74248","name":"X-ray sm int f-thru std","description":"Radiologic small intestine follow-through study, including multiple serial images (list separately in addition to code for primary procedure for upper gi radiologic examination)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31592","name":"Cricotracheal resection","description":"Cricotracheal resection","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9609.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1380.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-09-01","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01632","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B5100","name":"Parenteral solution hepatic","description":"Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, hepatic, hepatamine-premix","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21339","name":"Open nasoethmoid fx w/ fixj","description":"Open treatment of nasoethmoid fracture; with external fixation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["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","date_of_service":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38564","name":"Removal abdomen lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4485.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","UE","NU","TC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55700","name":"UNK","description":"UNK","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46900","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21141","name":"Rcnstj midface lefort i 1pc","description":"Reconstruction midface, lefort i; single piece, segment movement in any direction (eg, for long face syndrome), without bone graft","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1068.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"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","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57110","name":"Vagnc compl rmvl vag wall","description":"Vaginectomy, complete removal of vaginal wall;","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-09-01","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8227.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11983","name":"Remove/insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implant","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0323","name":"Care manage beh svs 20mins","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following required elements: initial assessment or follow-u","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","42","45","34"]},{"name":"ProviderCapacity","value":["PCP"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025","1/1/2025"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]},{"name":"DateOfServiceGreaterThanOrEqualTo","value":["1/1/2025"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","NU","RR","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62256","name":"Remove brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; without replacement","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95726","name":"Eeg phy/qhp>84 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of eeg recording, with video (veeg)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24930","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; re-amputation","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"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":"2026-09-01","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13153","name":"Cmplx rpr e/n/e/l addl 5cm/<","description":"Repair, complex, eyelids, nose, ears and/or lips; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47382","name":"Percut ablate liver rf","description":"Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency","date_of_service":"2026-09-01","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3381.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]}]}